Effectiveness of prophylactic gastrostomy in patients having treatment for head and neck cancer
Lorraine Guinan Head and neck clinical nurse specialist, The Royal Marsden NHS Foundation Trust, London
Sharon Rees Reader in pharmacotherapeutics, Faculty of Health and Social Care, London South Bank University
Lorraine Guinan and Sharon Rees report on a systematic review to evaluate the effectiveness of using a prophylactic gastrostomy compared with a therapeutic or no gastrostomy
Patients with head and neck cancer are at increased risk of malnutrition. There is much debate about the optimal method of feeding. A comprehensive literature review was conducted to compare the effectiveness of prophylactic gastrostomy versus no prophylactic gastrostomy in patients with head and neck cancer for the outcomes of treatment interruptions, unplanned admissions and weight changes, due to nutritional reasons. Ten articles were included in the review, including one randomised controlled trial, two cohort and seven case-controlled studies. Meta-analysis showed prophylactic gastrostomy significantly decreased unplanned admissions (P<0.0001). No statistical significance was shown for the treatment interruptions outcome (P=0.11). There was less percentage weight loss in the prophylactic gastrostomy group but statistical comparison was not applicable. Prophylactic gastrostomy decreases the number of unplanned admissions and may reduce weight loss. There is insufficient evidence to change practice but new knowledge is provided in the field.
Cancer Nursing Practice.
13, 8, 21-30.
This article has been subject to double blind peer review
Conflict of interest
Received: 13 June 2014
Accepted: 02 September 2014
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