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Published on: April 20, 2018
Prophylactic Versus Reactive (PvR) Feeding in Patients Undergoing (Chemo)radiation in Head and Neck Cancers: Results
Sarbani Ghosh Laskar1, Shwetabh Sinha1, Meenakshi Jeeva1
1Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
Background:
Optimal feeding strategy (Prophylactic vs. Reactive) during Radiation Therapy (RT) for Head and Neck Cancers (HNC) remains to be established.
Methods:
This phase III trial randomized (1:1) patients of HNC to prophylactic [nasogastric tube (NGT) placed at least 1 day before RT starting] versus reactive arm (NGT when required). The primary endpoint was the incidence of significant weight loss at 6 months. Secondary endpoints were weight changes, tube duration, dependence, and compliance.
Results:
Due to high denial rates, the trial was prematurely closed. Eighty-four patients (40-prophylactic, 44-reactive) were analyzed intention-to-treat. Seventeen patients (39%) required a reactive tube insertion. The proportion of patients with significant weight loss at 6 months in the prophylactic versus reactive arms was 13 (32.5%) versus 10 (15.9%), p = 0.44. The median tube duration was 56 days (IQR: 16.5-91) versus 47 days (IQR: 24-59), p = 0.255.
Conclusion:
Our limited analysis found that a reactive NGT should be considered for most HNC patients undergoing RT.
Trial Registration:
Clinical trials registry of India: CTRI/2020/01/023049.
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