This retrospective monocentric cohort study analyzed patients with head and neck cancer according their nutritional status and association of percutaneous endoscopic gastrostomy (PEG) from admission to six months after treatment at a tertiary hospital in Germany from 2017 to 2019. A total of 289 patients (76.5% men; median age 62 years; 63.3% stage IV) were included. Univariate analyses and ANOVAs with repeated measures were performed to analyze differences over time. The percentage of patients requiring PEG was 14.9% (43 of 289 patients) before start of treatment (Z0), 14% (40 of 286 patients alive) after one week (Z1), 22.7% (58 of 255 patients) after six weeks (Z2) and 23% (53 of 230 patients) after six months (Z3) from the end of treatment. PEG placement was associated with alcohol or nicotine consumption, in oropharyngeal and hypopharyngeal carcinoma, squamous cell carcinoma, cancer stage III/IV, chemotherapy and impairment of food intake (allp< 0.05). Weight loss between Z1 and Z3 with PEG did not differ from patients without PEG at Z0 (p= 0.074), although patients with PEG at Z0 had a lower mean weight at the beginning. PEG was important for a quarter of the patients alive at Z3 and helped to prevent weight loss.
本项回顾性单中心队列研究分析了2017年至2019年德国某三级医院收治的头颈癌患者，从入院至治疗后六个月的营养状况及其与经皮内镜下胃造口术（PEG）的相关性。共纳入289例患者（男性占76.5%；中位年龄62岁；63.3%为IV期）。采用单变量分析和重复测量方差分析评估时间差异。治疗开始前（Z0）需行PEG的患者比例为14.9%（289例中43例），治疗开始后一周（Z1）为14%（存活286例中40例），治疗结束后六周（Z2）为22.7%（255例中58例），治疗结束后六个月（Z3）为23%（230例中53例）。PEG置入与酒精或尼古丁摄入、口咽癌及下咽癌、鳞状细胞癌、III/IV期癌症、化疗及进食受损均显著相关（所有p<0.05）。尽管Z0期置入PEG的患者初始平均体重较低，但其在Z1至Z3期间的体重下降幅度与Z0期未置入PEG患者无显著差异（p=0.074）。PEG对Z3期存活患者中约四分之一具有重要意义，并有效防止了体重下降。
肿瘤(癌症)患者之家