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Tube Feeding May Improve Adherence to Radiation Treatment Schedule in Head and Neck Cancer: An Outcomes Study

Zogbaum, Ann T. MS, RD; Fitz, Polly MA, RD; Duffy, Valerie B. PhD, RD

Clinical Practice Issues

Head and neck cancer patients have a high risk of malnutrition because of lifestyle and dietary factors that may precipitate the disease, the disease itself, and therapies that often hinder feeding by mouth. Medical nutrition therapy (MNT) for the cancer patient aims to promote positive health and quality of life outcomes through provision of nutritional care. Outcomes research evaluates the effectiveness of MNT to produce these desired results. The present study determined if tube feedings, initiated prior to and continued throughout the radiation therapy, were associated with compliance with radiation therapy and weight maintenance in head and neck cancer patients. A chart review of a Tumor Registry at a metropolitan, tertiary care center from 1989–1995 identified 125 head and neck cancer patients treated with radiation therapy, 21 of whom were tube fed. Seventeen tube-fed patients with complete medical information were matched with 17 non–tube-fed patients (based on primary tumor site, disease stage, total radiation dosage, treatment with chemotherapy and/or surgery, and age) for a comparison of weight changes across the radiation therapy and number of missed treatment days. Groups did not differ on weight lost from preillness to disease presentation. The tube feeding group was associated with fewer missed treatment days and less weight loss. These concurrent findings suggest that the tube feeding supported the patient's nutritional status and improved treatment adherence. Prospective studies will test this supposition empirically. Nonetheless, the chart review offers a time-efficient process to evaluate the outcomes of MNT.

From the Helen and Harry Gray Cancer Center at Hartford Hospital, Hartford, Conn (Zogbaum)

The School of Allied Health, University of Connecticut, Storrs, Conn. (Fitz, Duffy)

The authors thank the Hartford Hospital Cancer Registry and the Radiation Therapy Department of Hartford Hospital for making it possible to conduct this study. The authors also acknowledge the work of Susanna Farkas, RD and Christianne R. Pease, RD who, at the time of the research, were dietetic interns and worked on this project as part of a 3-week research rotation.

Corresponding author: Valerie B. Duffy, PhD, RD, School of Allied Health, University of Connecticut, 358 Mansfield Rd, Unit 2101, Storrs, CT 06269 (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.