1400 Nutritional support in head and neck cancer patients

Abstract

Nutritional support is an important consideration in the overall management of the head and neck cancer patient. Anti tumour therapies impair nutritional intake: extensive surgical resection can interfere with mastication and deglutition; radiotherapy may limit oral intake by reactive changes. This study is a review of the nutritional management provided for all patients undergoing enteral feeding via nasogastric (NG) and gastrostomy (PEG) routes concurrent to radiotherapy treatment at the Clatterbridge Centre for Oncology July 1993–present. Mean nutritional requirements, method of delivery, type and composition of enteral feed, duration of nutritional support, percentage weight changes and alterations in body mass index (BMI) for each method of enteral feeding will be analysed and the outcome of each feeding method determined. Preliminary results indicate the feeding methods to be equally effective at maintaining body weight (NG = −10.8% to +20.1%, PEG = −9% to +19%) and BMI (NG = −2.3% to +3, PEG = 2.4 to +4). There are marked differences in the method of delivery of the feed between the two groups; NG feeding is predominantly administered continuously [n = 42 (85.7%)]. Whereas PEG feeding is delivered via bolus [n = 11 (39.3%)] and continuous methods [n = 10 (35.7%)]. PEG feeding via bolus method allows an increase in the quality of life for the patient by allowing normal feeding patterns and increased mobility. The placement of a PEG in preference to an NG tube is considered to be more discreet and cosmetically pleasing for the patient.