Abstract

Background: The benefits of artificial nutrition and hydration in patients with head and neck cancer and esophageal cancer in the late stage remain unknown. We performed a secondary analysis of a cohort study to investigate the effects of enteral tube feeding (ETF) and parenteral nutrition and hydration (PNH) on survival in this population. Methods: Patients with head and neck cancer and esophageal cancer admitted to palliative care units were included. Information on primary nutritional administration routes during the first week of admission and data on the averaged calorie sufficiency rate/total calorie intake, e.g., 75%≤/750 kcal/day≤ and <25%/<250 kcal/day, were obtained. Patients were divided into oral intake-, ETF-, and PNH-groups. We performed time-to-event analyses using the Kaplan-Meier method, Log-rank test, and univariate and multivariate Cox regression analyses. Results: There were 33 patients in the oral intake-group, 25 in the ETF-group, and 44 in the PNH-group. A significant difference was observed in survival rates between these groups (Log-rank P = 0.002), and median survival times were 54.0 (95% CI 33–75), 26.0 (95% CI 13–39), and 18.0 (95% CI 14–22) days, respectively. In the multivariate-adjusted model, the oral intake-group had a significantly lower risk of mortality than the PNH-group [HR 0.46 (95% CI 0.28–0.76), P = 0.002], while the ETF-group had a markedly lower risk of mortality than the PNH-group [HR 0.60 (95% CI 0.34–1.06), P = 0.077]. Conclusions: These results indicate the potentially beneficial effects of ETF for patients with head and neck cancer and esophageal cancer in palliative care.

Original languageEnglish
Pages (from-to)33-43
Number of pages11
JournalClinical Nutrition Open Science
Volume41
DOIs
Publication statusPublished - 2022 Feb

Keywords

  • Cachexia
  • Enteral nutrition
  • Esophageal cancer
  • Head and neck cancer
  • Palliative care
  • Parenteral nutrition

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