Supportive Care in Cancer

, Volume 1, Issue 5, pp 272–275 | Cite as

The influence of supportive nutritional therapy via percutaneous endoscopically guided gastrostomy on the quality of life of cancer patients

  • M. Senft
  • R. Fietkau
  • H. Iro
  • D. Sailer
  • R. Sauer
Short Communications


Between April 1987 and May 1990 a total of 212 consecutive patients with tumours in the head and neck region were admitted to a prospective study comparing planned prospective enteral nutrition via percutaneous endoscopically guided gastrostomy (PEG; n=47) and oral nutrition (n=134). The nutritional status (anthropometric and laboratory chemical parameters) and the quality-of-life index according to Padilla et al. [Res Nurs Health 6: 117–126 (1983)] were determined prior to radiotherapy, 2, 4, 6 weeks later during radiotherapy and 6, 12 and 18 weeks after completion of radiotherapy. The quality-of-life score of the orally nourished patients decreased quickly during radiotherapy and improved only slowly afterwards. Although PEG patients had a worse starting score, their quality-of-life index did not deteriorate during therapy (statistically significant difference between the two groups). The same applies to the nutritional status. These results show that an early and constant enteral nutrition by PEG can stabilize the nutritional state and the quality of life of patients with tumours of the head and neck area during radiotherapy.

Key words

Nutritional therapy PEG Quality of life Cancer patients 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aaronson NK (1992) Assessing the quality of life of patients in cancer clinical trial: common problems and common sense solutions. Eur J Cancer 28:1304–1307Google Scholar
  2. 2.
    Bjordal K, Kaasa S (1992) Psychometric validation of the EORTC core quality of life questionnaire, 30-item version and a diagnosis-specific module for head and neck cancer patients. Acta Oncol 31:321–321Google Scholar
  3. 3.
    Cella DF, Tulsky DS (1990) Measuring quality of life today: methodological aspects. Oncology 4:29–38Google Scholar
  4. 4.
    Coates A, Gebski M, Bishop J, Fischer-Dillenbeck C, McNeil DR, Kaye SB, Sims K, Fox RM, Woods RL, Milton GW, Solomon J, Tattersall MHN (1987) Improving the quality of life during chemotherapy for advanced breast cancer. N Engl J Med 317:1490–1495Google Scholar
  5. 5.
    Donovan K, Sanson-Fisher RW, Redman S (1989) Measuring quality of life in cancer patients. J Clin Oncol 7:959–968Google Scholar
  6. 6.
    Fietkau R (1992) Percutaneous endoscopically guided gastrostomy feeding. Proceedings of 7th International Conference on Cancer Nursing, Vienna 1992.Google Scholar
  7. 7.
    Fietkau R, Iro H, Grabenbauer GG, Altendorf-Hofmann A, Sauer R (1991) Simultane Radio-Chemotherapie mit Cisplatin and 5-Fluorouracil bei fortgeschrittenen Kopf-Hals-Tumoren. Strahlenther Onkol 167:693–700Google Scholar
  8. 8.
    Fietkau R, Weidenbecher M, Spitzer W, Sauer R (1991) Temporary and permanent brachycurie therapy in advanced head and neck cancer-the Erlangen experience. In: Sauer R (ed) Interventional radiation therapy: techniques-brachytherapy. Springer, Berlin Heidelberg New York, pp 159–169Google Scholar
  9. 9.
    Finkelstein DM, Cassileth BR, Bonomi PD (1988) A pilot study of the functional living index-cancer (FLIC) scale for the assessment of quality of life for metastatic lung cancer patients. Am J Clin Oncol 11:630–633Google Scholar
  10. 10.
    Fossa SD, Aaronson NK, Newling D (1990) Quality of life and treatment of hormone resistant metastatic prostate cancer. Eur J Cancer 26:1133–1136Google Scholar
  11. 11.
    Ganz PA, Haskell CM, Figlin RA, LaSoto N, Siau J (1988) Estimating the quality of life in a clinical trial of patients with metastatic lung cancer using the Karnofsky performance status and the functional living index-cancer. Cancer 61:849–856Google Scholar
  12. 12.
    Gauderer MWL, Ponsky JL, Iznt RZ (1980) Gastrostomy without laparatomy: a percutaneous endoscopic technique. J Pediatr Surg 15:872Google Scholar
  13. 13.
    Haes JCJM de, Oostrom MA van, Welvaart K (1986) The effect of radical and conserving surgery on the quality of life of early breast cancer patients. Eur J Surg Clin Oncol 12:337–342Google Scholar
  14. 14.
    Hopwood P (1992) Progress, problems and priorities in quality of life research. Eur J Cancer 28:1748–1752Google Scholar
  15. 15.
    Iro H, Kachlik H-G, Fietkau R, Thiel H-J, Kolb S (1986) Erfahrungen mit der perkutanen endoskopisch kontrollierten Gastrostomie (PEG) bei HN0-Tumorpatienten. HNO 36:111–114Google Scholar
  16. 16.
    Iro H, Fietkau R, Weidenbecher M, Rüppel W, Steiner W (1991) Behandlungsergebnisse bei fortgeschrittenen supraglottischen Malignomen. In: Dühmke E, Steiner W, Reck R (eds) Funkstionserhaltende Therapie des fortgeschrittenen Larynx-Karzinoms. Thieme, Stuttgart New York, pp 78–79Google Scholar
  17. 17.
    Kiebert GM, Haes JCJM de, Velde CJH van de (1991) The impact of breast conserving treatment and mastectomy on the quality of life of early stage breast cancer patients: a review. J Clin Oncol 9:1059–1070Google Scholar
  18. 18.
    Padilla G, Presant C, Grant MM, Metter G, Lipsett J, Heide F (1983) Quality of life index for patients with cancer. Res Nurs Health 6:117–126Google Scholar
  19. 19.
    Ponsky JL, Gauderer MWL, Stellato TA (1983) Percutaneous endoscopic gastrostomy. Surgery 118:913Google Scholar
  20. 20.
    Sauer R (1987) Perkutane Stahlentherapie der Oropharynxund Hypopharynxkarzinome. In: Sauer R, Schwab W (eds) Kombinationstherapie der Oropharynx-und Hypopharynxkarzinome. Urban & Schwarzenberg, München Wien Baltimore, pp 32–43Google Scholar
  21. 21.
    Schipper H (1990) Guidelines and caveats for quality of life measurement in clinical practical and research. Oncology 4:51–57Google Scholar
  22. 22.
    Strain JJ (1990) The evolution of quality of life evaluations in cancer therapy. Oncology 4:22–26Google Scholar
  23. 23.
    Sugarbaker PH, Barofsky I, Rosenberg SA, Gianola FJ (1982) Quality of life assessment of patients in extremity sarcoma clinical trials. Surgery 91:17–23Google Scholar
  24. 24.
    Thiel H-J, Fietkau R, Sauer R (1988) Malnutrition and the role of nutritional support for radiation therapy patients. Recent Results Cancer Res 108:205–222Google Scholar
  25. 25.
    UICC (1987) TNM Atlas. Illustrated guide to the classification of malignant tumours. Springer, Berlin Heidelberg New YorkGoogle Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • M. Senft
    • 1
  • R. Fietkau
    • 1
  • H. Iro
    • 2
  • D. Sailer
    • 3
  • R. Sauer
    • 1
  1. 1.Strahlentherapeutische UniversitätsklinikErlangenGermany
  2. 2.Nasen-und Ohren-KlinikUniversitäts-HalsErlangenGermany
  3. 3.Medizinische Klinik I der UniversitätErlangenGermany

Personalised recommendations