Comparison between nasogastric tube feeding and percutaneous fluoroscopic gastrostomy in advanced head and neck cancer patients

Wasting is a major complication of advanced head and neck cancer and the ai m of this: study was to compare nasogastric tube feeding (NG) and percutane ous fluoroscopic gastrostomy (PFG) in these patients. The goal of these two methods of nutritional support was to improve or maintain the initial nutr itional status during treatment. A total of 90 patients, ail stage IV oroph arynx or hypopharynx tumor, were reviewed from a prospective databank. All these patients were treated by concomitant chemotherapy and twice-daily con tinuous radiotherapy with no acceleration. Fifty patients were managed by P FG, and the rest by NG. Mechanical failure, duration of feeding, complicati ons, nutritional evaluation and quality of life were analysed. Mechanical f ailure occurred in 32 of the 40 NG patients and in seven of the gastrostomy group. In the PFG group, 80% of patients conserved their nutritional suppo rt after the end of the radiotherapy, none patient in the NG group. In the PFS group, two presented a wound infection and six had aspiration pneumonia while in the NG group, 21 had aspiration pneumonia probably due to the NG tube (gastroesophageal reflux). The feeding methods were found to be equall y effective at maintaining body weight and body mass index at time 1 (3 wee ks) and at time 2 (6 weeks). Advantages were associated with PFG cosmesis, mobility and quality of life. PFG is a safe and effective method of providi ng enteral nutrition during treatment to patients with advanced head and ne ck cancer and offers important advantages over NG.