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Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists.

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Title: Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists.
Authors: Dragan, Tatiana1 (AUTHOR) tatiana.dragan@bordet.be, Duprez, Fréderic2 (AUTHOR), Van Gossum, André3 (AUTHOR), Gulyban, Akos4 (AUTHOR), Beauvois, Sylvie1 (AUTHOR), Digonnet, Antoine5 (AUTHOR), Lalami, Yassine6 (AUTHOR), Van Gestel, Dirk1 (AUTHOR)
Source: BMC Cancer. 6/2/2021, Vol. 21 Issue 1, p1-8. 8p.
Subject Terms: *HEAD & neck cancer, *TUBE feeding, *GASTROSTOMY, *ENTERAL feeding, *ONCOLOGISTS, *RADIATION
Abstract: Background: Nutritional complications in patients with locally advanced head and neck cancer (LA-HNC) treated by concurrent chemoradiotherapy (CCRT) often lead to placement of a prophylactic gastrostomy (PG) tube, while indication lacks harmonization. Our aim was to explore the current PG tube utilization among Belgian radiation oncology centers.Methods: A survey was distributed to all 24 Belgian Radiation oncology departments, with questions about the number of patient treated per year, whether the PG indication is discussed at the multidisciplinary board, placement technique, time of starting nutrition and removal, its impact on swallowing function and importance of clinical factors. For the latter Relative Importance and Discordance Indexes were calculated to describe the ranking and agreement.Results: All 24 centers submitted the questionnaire. Twenty three treat more than 20 head and neck (HNC) patients per year, while four (1 in 21-50; 3 in 51-100) are not discussing the gastrostomy tube indication at the multidisciplinary board. For the latter, endoscopic placement (68%) is the dominant technique, followed by the radiologic (16%) and laparoscopic (16%) methods. Seventy-five percent start the enteral nutrition when clinically indicated, 17% immediately and 8% from the start of radiotherapy. Majority of specialists (19/24) keep the gastrostomy tube until the patient assume an adequate oral feeding. Fifteen centres are considering PG decrease swallowing function. Regarding factors and their importance in the decision for the PG, foreseen irradiated volume reached highest importance, followed by 'anatomical site', 'patients' choice' and 'postoperative versus definitive' and 'local expertise', with decreasing importance respectively. Disagreement indexes showed moderate variation.Conclusions: The use of a PG tube for LAHNC patients treated by CCRT shows disparity at national level. Prospective studies are needed to ensure proper indication of this supportive measure. [ABSTRACT FROM AUTHOR]
Copyright of BMC Cancer is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Prophylactic gastrostomy in locally advanced head and neck cancer: results of a national survey among radiation oncologists.
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  Data: <searchLink fieldCode="AR" term="%22Dragan%2C+Tatiana%22">Dragan, Tatiana</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> tatiana.dragan@bordet.be</i><br /><searchLink fieldCode="AR" term="%22Duprez%2C+Fréderic%22">Duprez, Fréderic</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Van+Gossum%2C+André%22">Van Gossum, André</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gulyban%2C+Akos%22">Gulyban, Akos</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Beauvois%2C+Sylvie%22">Beauvois, Sylvie</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Digonnet%2C+Antoine%22">Digonnet, Antoine</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lalami%2C+Yassine%22">Lalami, Yassine</searchLink><relatesTo>6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Van+Gestel%2C+Dirk%22">Van Gestel, Dirk</searchLink><relatesTo>1</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22BMC+Cancer%22">BMC Cancer</searchLink>. 6/2/2021, Vol. 21 Issue 1, p1-8. 8p.
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  Data: *<searchLink fieldCode="DE" term="%22HEAD+%26+neck+cancer%22">HEAD & neck cancer</searchLink><br />*<searchLink fieldCode="DE" term="%22TUBE+feeding%22">TUBE feeding</searchLink><br />*<searchLink fieldCode="DE" term="%22GASTROSTOMY%22">GASTROSTOMY</searchLink><br />*<searchLink fieldCode="DE" term="%22ENTERAL+feeding%22">ENTERAL feeding</searchLink><br />*<searchLink fieldCode="DE" term="%22ONCOLOGISTS%22">ONCOLOGISTS</searchLink><br />*<searchLink fieldCode="DE" term="%22RADIATION%22">RADIATION</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Background: </bold>Nutritional complications in patients with locally advanced head and neck cancer (LA-HNC) treated by concurrent chemoradiotherapy (CCRT) often lead to placement of a prophylactic gastrostomy (PG) tube, while indication lacks harmonization. Our aim was to explore the current PG tube utilization among Belgian radiation oncology centers.<bold>Methods: </bold>A survey was distributed to all 24 Belgian Radiation oncology departments, with questions about the number of patient treated per year, whether the PG indication is discussed at the multidisciplinary board, placement technique, time of starting nutrition and removal, its impact on swallowing function and importance of clinical factors. For the latter Relative Importance and Discordance Indexes were calculated to describe the ranking and agreement.<bold>Results: </bold>All 24 centers submitted the questionnaire. Twenty three treat more than 20 head and neck (HNC) patients per year, while four (1 in 21-50; 3 in 51-100) are not discussing the gastrostomy tube indication at the multidisciplinary board. For the latter, endoscopic placement (68%) is the dominant technique, followed by the radiologic (16%) and laparoscopic (16%) methods. Seventy-five percent start the enteral nutrition when clinically indicated, 17% immediately and 8% from the start of radiotherapy. Majority of specialists (19/24) keep the gastrostomy tube until the patient assume an adequate oral feeding. Fifteen centres are considering PG decrease swallowing function. Regarding factors and their importance in the decision for the PG, foreseen irradiated volume reached highest importance, followed by 'anatomical site', 'patients' choice' and 'postoperative versus definitive' and 'local expertise', with decreasing importance respectively. Disagreement indexes showed moderate variation.<bold>Conclusions: </bold>The use of a PG tube for LAHNC patients treated by CCRT shows disparity at national level. Prospective studies are needed to ensure proper indication of this supportive measure. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of BMC Cancer is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1186/s12885-021-08348-9
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        Text: English
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      – SubjectFull: HEAD & neck cancer
        Type: general
      – SubjectFull: TUBE feeding
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      – SubjectFull: GASTROSTOMY
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              Text: 6/2/2021
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