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Tolerance and efficacy of preventive gastrostomy feeding in pediatric oncology
Author(s) -
Schmitt Françoise,
Caldari Dominique,
Corradini Nadège,
Gicquel Philippe,
Lutz Patrick,
Leclair MarcDavid,
Podevin Guillaume
Publication year - 2012
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24161
Subject(s) - medicine , malnutrition , gastrostomy , blood cancer , percutaneous endoscopic gastrostomy , enteral administration , parenteral nutrition , incidence (geometry) , complication , cancer , medical record , pediatric cancer , weight loss , pediatrics , quality of life (healthcare) , surgery , peg ratio , physics , nursing , finance , optics , economics , obesity
Background Malnutrition in pediatric oncology remains underestimated, although having a negative impact on outcome. Enteral nutrition (EN) using percutaneous endoscopic gastrostomy (PEG) may prevent or reverse malnutrition consequences. We aimed to evaluate both efficacy and safety of early EN during tumors treatment in children. Procedures Medical records of pediatric patients having a PEG tube inserted between 1995 and 2009 were retrospectively reviewed. We compared type and incidence of complications in Group 1, including 74 patients suffering from cancer, and control Group 2, including 57 patients with neurological impairment. Efficacy of EN was evaluated through nutritional parameters [Z‐scores weight for height (W/H) and height for age (H/A)], post‐operative complications and relapse rates. Statistical significance was set for P < 0.05. Results PEG tolerance was similar in both groups, as shown by comparable complication rates (62% vs. 76%, NS). EN allowed improvement or stabilization of Z‐score W/H in 76% of oncologic patients. The final height loss was lower (−0.5 vs. −1.2 SD of Z‐scores H/A) when EN was started at the beginning of the oncologic treatment. In bone tumors, EN prevented weight loss during chemotherapy, and tended to lessen surgical complications, relapses and deaths. Conclusions Early gastrostomy feeding represents a relatively safe way to prevent malnutrition in children with cancer, and might play a role in bone tumors oncological outcome. Further prospective studies are needed to confirm these results and assess the impact of EN and PEG on quality of life. Pediatr Blood Cancer 2012; 59: 874–880. © 2012 Wiley Periodicals, Inc.