Nasogastric tube feeding in children with cancer as a part of palliative care

Abstract

Background/Objectives: Many paediatric oncology patients lose weight because of their inability to consume adequate caloric intake orally. Poor nutrition is associated with malnutrition and poor prognosis of the disease. Thus nutritional support is an important element of palliative care. Enteral nutrition (EN) is the preferred method as long as if the gastrointestinal tract is functioning. We aimed to demonstrate whether EN is feasible in daily practice of these patients. Design/Methods: Nutritional records of children with cancer treated between May 2011- Jan 2016 at Bezmialem Vakif University Pediatric Haematology and Oncology were evaluated. Patients with poor oral intake were fed with commercial use formulas by the oral route, by the nasogastric tube (NG) and by percutaneous endoscopic gastrostomy (PEG). Patients who lost weight under the support of oral route were fed by NG. Weight of the patients were checked at every week. Children with diffuse pontine glioma after losing gag reflex, were fed by PEG. No other patients had PEG. Results: A total of 125 (81.6%) among 153 patients required nutritional support. Forty-eight (38.4%) of them were fed by oral route, 67 (53.6%) patients were fed by NG only. Ten (8%) DPG patients initially fed by NG had PEG later. Median duration of oral supplementation was 106 (68-154) days. Median duration of NG was 23 (7-96) days. All the patients other than DPG gained or maintained their weight. No major complication occured in the patients. Conclusion: Weight loss is an important problem in patients with cancer. Patients who lost weight under the support of oral route should be fed by NG. Palliative enteral feeding by NG tube is safe, inexpensive, and has a low complication rate. NG feeding, rather than PEG, could be a more appropriate method of enteral feeding in children with cancer.