PWE-226 Enteral feeding in non-surgical oncology- it–s not just head and neck and upper GI cancers. (22nd June 2015)

• Record Type: Journal Article
• Authors: White, R; Freemantle, S; Bracegirdle, R; Chowdhury, S; Roy, M; Kegey, O; Siemicka, M
• Is Part Of: Gut. Volume 64(2015)Supplement 1
• Page Start: A311
• Page End: A311
• Publication Date: 2015-06-22
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2015-309861.672
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Introduction: A significant amount of head and neck (H&N) and upper gastrointestinal (UGI) cancer patients require enteral nutrition (EN) at home. At our centre in 2014 alone we established 156 H&N patients and 52 UGI patients on home EN. However, a significant proportion of cancer patients with other tumours may also require EN. ESPEN guidelines recommend EN should be considered if under-nutrition exists, oral intake is < 60% of requirements and prognosis exceeds 2–3 months. 1 Our aim was to determine the extent of EN use in non-surgical oncology patients (excluding H&N and UGI patients) and to compare its use against ESPEN guidelines. Method: We undertook a retrospective review of dietetic records between January 2013 and December 2014 for all patients who required home EN. Data was analysed descriptively. Results: 17 patients were initiated on EN during the data collection period. 16 patients were fed via naso-gastric tube (NGT) and 1 via percutaneous endoscopic gastrostomy (PEG), with 2 of the NGT's later converted to gastrostomies. Table 1 shows the number of patients with EN by tumour site and stage of cancer pathway. The main indication for EN was dysphagia secondary to disease (76%), oesophagitis secondary to radiotherapy (12%), inadequate oral intake (6%) and tracheal-oesophageal fistula (6%). 12 patients were nil by mouth due to aspiration risk and 5 were managing < 60% of estimated nutritional requirements. Only 3 (18%) patients were given a predicted prognosis of <3 months but all were fed following MDT discussion with the aim of improving quality of life (QOL). Conclusion: A small but significant proportion of oncology patients require home EN outside of H&N and UGI cancers. In particular lung cancer patients may have a need for EN due to swallowing difficulties where the cause can be multifactorial. 2 Our practice appears compliant with ESPEN guidelines with all patients managing less than 60% of requirements on initiation of feeding and prognosis was > 3 months in all but 3 patients. However, the effectiveness of EN is rarely recorded and greater consideration should be given to validated outcome measures both in terms of anthropometry and QOL. Disclosure of interest: None Declared. References: Arends J, et al . ESPEN Guidelines on Enteral Nutrition: Non surgical oncology. Clin Nutr. 2006;25:245–259. Camidge D. The causes of dysphagia in carcinoma of the lung. J Roy Soc Med. 2001;94:567–572.