Purpose: To evaluate the effects of feeding tube placement on patient weight and length of treatment breaks during definitive radiotherapy with at least 50 Gy to the bilateral necks of patients with head and neck (H&N) cancer.
Methods: Thirty-five H&N cancer patients underwent definitive radiotherapy at the Radiation Oncology Department at Michael E. DeBakey VA Medical Center from July 23, 2012 to April 25, 2013. Twenty-three patients received doses of ≥ 50 Gy to bilateral necks, and constituted the study group. The remaining 12 patients did not receive ≥ 50 Gy and were excluded from the study. Among the 23 patients, 11 underwent feeding tube placement (group 1). Group 2 consisted of 12 patients without feeding tubes. All patients with feeding tube placement had concurrent chemotherapy. Some patients in group 2 received radiation treatment only.
Results: Twenty-two patients had weight loss, 1 patient gained 6.9 lb during the course of treatment. The median weight loss for group 1 was 17.8 lb (ranging from 4.4 to 34.4 lb), compared with 18.6 lb in patients in group 2. Those in group 2 who only received radiation therapy had the least median weight loss (5.4 lb). The average treatment break was 3.3 days for patients in group 1, 3.7 days for those in group 2 with concurrent chemo-radiotherapy (chemoRT), and 3.2 days for group 2 subjects receiving radiation therapy only.
Conclusions: In H&N cancer patients, feeding tube placement did not minimize weight loss and did not reduce average treatment breaks in those given concurrent chemoRT. An interesting additional finding of the study was that chemotherapy seems to have greater impact on a patient’s ability to tolerate radiation therapy. Our findings in this small, retrospective study, though suggestive, are insufficient to draw any definitive conclusions about the effectiveness of prophylactic feeding tube placement in the target patient population. Published studies on this subject are contradictory. Treatment decisions should be based on physician expertise and individualized to clinical needs of patients.