Effect of prophylactic tube feeding in head and neck cancer patients with high Mallampati score undergoing definitive concurrent chemoradiotherapy

• Published in: Supportive care in cancer Vol. 31; no. 7; p. 384
• Main Authors: Lu, Chang-Hsien, Hsu, Chih-Chung, Su, Po-Hsu, Lin, Shinn-Yn, Yeh, Kun-Yun, Hsueh, Shun-Wen, Chang, Joseph Tung-Chieh, Wang, Hung-Ming, Hung, Yu-Shin, Chou, Wen-Chi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2023; Springer Nature B.V
• Subjects: Chemoradiotherapy - adverse effects; Chemotherapy; Clinical outcomes; Enteral nutrition; Head & neck cancer; Head and Neck Neoplasms - therapy; Humans; Medicine; Medicine & Public Health; Nursing; Nursing Research; Oncology; Pain Medicine; Quality of Life; Radiation therapy; Rehabilitation Medicine; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck - therapy; Head and neck cancer; Prophylactic tube feeding; Concurrent chemoradiotherapy; Mallampati score; Quality of life
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-023-07859-4

Purpose There is no consensus on the selection of appropriate prophylactic tube feeding in patients with head and neck squamous cell carcinoma (HNSCC) undergoing concurrent chemoradiotherapy (CCRT). This study aimed to evaluate the effect of prophylactic tube feeding in patients with HNSCC who presented with a high Mallampati score and underwent CCRT. Methods We prospectively enrolled 185 consecutive patients with stage II to IVa HNSCC and a pre-treatment Mallampati score of 3 or 4 who received CCRT between August 2017 and December 2018 with follow-up data collected retrospectively. Patients were divided to either with or without prophylactic tube feeding group for comparison of treatment tolerance, toxicities, and quality of life(QOL). Propensity score matching (PSM) was used to achieve balanced covariates across the two groups. Results Of the cohort, 52 (28.1%) and 133 (71.9%) patients were allocated to the prophylactic and non-prophylactic tube feeding groups, respectively. Before and after PSM, patients in the tube feeding group had a significantly lower incidence of incomplete radiotherapy, incompletion of chemotherapy, emergency room visits, and grade 3 or higher infection, and improved symptoms of quality of life after CCRT than those in the non-tube feeding group. Conclusion Prophylactic tube feeding was associated with better treatment tolerance, safety profiles, and quality of life in patients with HNSCC and high Mallampati scores who underwent CCRT. Therefore, Mallampati score might serve as a clinical tool for proactive selection of patients receiving prophylactic tube feeding in HNSCC patients upon receiving CCRT.