Prophylactic versus reactive feeding approach in patients undergoing adjuvant radiation therapy for oral cavity squamous cell carcinoma: A propensity score matched-pair analysis

Head Neck. 2023 May;45(5):1226-1236. doi: 10.1002/hed.27336. Epub 2023 Mar 13.

Abstract

Background: To assess the efficacy of prophylactic versus reactive feeding strategy in oral cavity squamous cell carcinoma (OCSCC) patients receiving adjuvant radiation therapy (RT).

Methods: This was a post hoc analysis of patients of OCSCC enrolled in a randomized trial comparing three adjuvant strategies. In this trial, till 2010, a prophylactic feeding approach was followed for all patients. Since January 2011, a reactive feeding approach was followed.

Results: Two hundred and sixty-eight in each cohort (total n = 526) were eligible for analysis after propensity score matching. At 6 weeks post-RT completion, the median weight loss in the prophylactic versus reactive cohort was 5 versus 3 kg, p = 0.002. At all other time points until 1 year, the median weight loss was lesser in reactive than in the prophylactic cohort.

Conclusions: A reactive feeding tube approach should be preferred for OCSCC receiving adjuvant RT.

Keywords: nasogastric tube; oral cancers; percutaneous endoscopic gastrostomy; prophylactic feeding tube; reactive feeding.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Gastrostomy
  • Head and Neck Neoplasms*
  • Humans
  • Matched-Pair Analysis
  • Mouth Neoplasms* / pathology
  • Propensity Score
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Weight Loss