This article is more than 5 years old. Information may no longer be current.
Smoking, alcohol may increase gastrostomy duration in head and neck cancers
Click Here to Manage Email Alerts
Patients with head and neck cancers who undergo prophylactic gastrostomy tube insertion before radiotherapy or chemoradiotherapy are more likely to have a lengthier duration on the feeding tube if they are current smokers or heavy consumers of alcohol, according to study results.
Although chemoradiotherapy is a common treatment of advanced head and neck cancers, its high levels of toxicity often affect eating and lead to weight loss and malnutrition. As such, the gastrostomy tube (GT) insertion prior to treatment is often recommended, according to the study background.
Patrick Sheahan, MB, MD, FRCSI, of the South Infirmary Victoria University Hospital in Cork, Ireland, and colleagues conducted a retrospective study to determine whether current smoking and current heavy alcohol use could be predictive of the need for a prolonged GT requirement.
The study included 104 patients with squamous cell cancer of the head and neck who underwent treatment with chemoradiation (n = 84) or radiotherapy alone (n = 20) at an academic teaching hospital in Ireland.
The data indicated that the median duration of GT use was 9 months, with a 35% rate of GT use at 12 months.
The researchers found that current smoking (HR = 0.47; 95% CI, 0.27-0.81) and current heavy consumption of alcohol (HR = 0.55; 95% CI, 0.32-0.97) were predictive of the persistent need for the feeding tube. However, multivariate analysis showed current smoking (HR = 0.53; 95% CI, 0.3-0.94) was the only variable significantly associated with need for the feeding tube.
Furthermore, other variables such as advanced age (age 65 years and older), advanced tumor site classification, larynx and/or hypopharynx primary site and posttreatment neck dissection were not considered significant risk factors.
The investigators suggested the reasons that smoking and alcohol consumption had an effect on GT duration were likely multifactorial.
“Smoking has been reported to increase the severity of mucositis, while nicotine may suppress appetite, leading to less effort by the patient to resume full oral diet,” the researchers wrote.
They added that deficits in nutrition are common among heavy drinkers, which also could mandate lengthier GT use.
“[This] raises the question whether smoking and drinking cessation prior to treatment may lessen the risk of long-term GT use,” the researchers wrote. “Our results would support advising patients with head and neck squamous cell carcinoma undergoing radiotherapy or chemoradiotherapy to avoid smoking and excess alcohol consumption during treatment.
“However, to determine whether stopping smoking and drinking can shorten duration of GT use will require further data from prospective studies,” they wrote. – by Anthony SanFilippo
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts