Report in Brief
Guidelines on non-oral feeding for patients with head or neck cancer do not recommend a specific feeding method.
A randomized controlled trial comparing methods for the non-oral feeding of patients with head or neck cancer undergoing chemoradiotherapy or radiotherapy is currently underway, with results expected in mid-2016.
- What is the clinical effectiveness of nasogastric feeding tubes compared with percutaneous endoscopic gastronomy for patients with head or neck cancer?
- What are the evidence-based guidelines regarding the use of nasogastric feeding tubes in an outpatient setting for patients with head or neck cancer?
Patients with advanced head and neck (HN) cancer may not receive adequate nutrition orally. Non-oral (enteral) alternatives include feeding via a nasogastric (NG) tube when the issue becomes a problem (the traditional approach) or via percutaneous endoscopic gastronomy (PEG) prophylactically or when needed (a more recent approach). Due to a lack of RCTs, there is limited evidence to support one treatment method over the other. In part, the issue has been lack of willingness of these very ill and vulnerable patients to be randomized. It also appears that individualized treatment is optimal as patients’ preferences vary. An RCT to test the feasibility of a larger comparative RCT has been launched in England with results expected mid-2016. In clinical practice guidelines, there was little distinction between outpatient and inpatient treatment in the guidance and also little distinction between NG tube versus PEG feeding.