Percutaneous endoscopic gastrostomy feeding of locally advanced oro-pharygo-laryngeal cancer patients: Blenderized or commercial food?

- HNC patients experienced significant body weight and lean tissue losses before diagnosis.
- Feeding through endoscopic gastrostomy must initiate before the onset of treatment.
- Blenderized homemade food is unsuitable, as it fails to restore protein loss.
- Commercial, oncology specific formulas, better sustain body weight and composition.
- 8-mo feeding is not enough for body weight and lean mass restoration.

ObjectivesHead and neck cancer patients commonly suffer from severe malnutrition at the time of tentative diagnosis. Percutaneous Endoscopic Gastrostomy [PEG] feeding is now considered as an efficient tool to reduce nutritional deterioration alongside concurrent treatment. We undertook the challenge to retrospectively evaluate the impact of a commercial, disease-specific, feeding formula [Supportan, Fresenius Kabi, Hellas] versus blenderized family food on nutritional outcome.Materials and methodsThis is a retrospective analysis of prospectively collected nutritional and anthropometric data at the time of PEG placement, at the 8th week [after treatment termination] and at 8 months [6mo of recovery from treatment]. All patients were prescribed a commercial feeding formula.ResultsThe final dataset included 212 patients: 112 received the commercial formula, 69 voluntarily decided to switch into blenderized-tube-feeding, and 31 were prescribed to receive a home-made formula of standard ingredients. The commercial formula seemed to help patients to fight the catabolism of concurrent treatment, since, at the 8mo assessment, both Body Mass index and Fat Free Mass had almost recovered to the values at the time of first diagnosis. Neither group on blenderized or home-made formulas exhibited nutritional improvement, but experienced a significant deterioration throughout the study period, with the home-made formula group being the worst.ConclusionThese findings clearly indicate that home-made and blenderized foods do not adequately support the nutritional requirements of patients with HNC scheduled to receive concurrent CRT treatment.