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Cancer of the head and/or neck (HN) describes malignant tumours that broadly include cancers of the lip, oral cavity, tongue, salivary glands, pharynx, larynx, nasal cavity, ear and skull base; 80% to 90% are squamous cell carcinomas (SCCs). For many patients with advanced stages of HN cancer, oral nutrition does not provide enough nourishment during treatment with chemoradiotherapy (CT) and/or radiotherapy (RT) due to the acute toxicity of treatment, obstruction caused by the tumour, or both. It has been reported that these patients are more likely to experience nutritional depletion than patients with any other cancer during all illness phases. Many patients enter treatment with weight loss and up to 80% lose additional weight during treatment; poor nutrition is linked with poor prognoses. In these cases, enteral nutrition (i.e., delivered straight to the intestine) is considered the best option. Non-oral / enteral supply of nutrients can be delivered directly into the stomach via a nasogastric (NG) feeding tube inserted through the nose into the stomach, or via a percutaneous endoscopic gastrostomy (PEG) inserted through the skin of the abdomen directly into the stomach. The latter can be inserted prophylactically before treatment starts or reactively when the patient needs it. The optimal method of non-oral feeding is controversial. Although several groups have developed predictive models to determine which patients will benefit from feeding tubes and when others believe the situation is too complex and multifactorial to make this type of tool usable. The purpose of this report is to assess the literature reporting on NG feeding tubes versus PEG for this patient group, including the guidance contained in relevant evidence-based CPGs.

Enteral feeding. --- Stomach --- Tube feeding. --- Neck --- Intubation. --- Cancer. --- Enteral Nutrition. --- Gastrostomy. --- Cancer --- Clinical medicine --- Evidence-based medicine --- Feeding tube --- Health --- Health care --- Health sciences --- Medical specialties --- Medicine --- National institute for health and care excellence

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Gastrointestinal Diseases --- Diet --- Feeding Behavior --- Digestive System Diseases --- Enteral Nutrition. --- Nutritional Requirements. --- therapy. --- dieet --- pancreatitis --- maagulcus --- gastro-oesofageale reflux --- Gastroenterology --- Nutritionary hygiene. Diet --- darmziekten --- leverziekten --- 616.34 --- 613.2 --- gastro-enterologie --- 628.44 --- diarree --- hepatitis --- Dieet --- Gastroenterologie (maagdarmstelsel, maagdarmziekten) --- 628.8 --- dieet (gez) --- gastro-enterologie (gez) --- Crohnziekte --- colitis ulcerosa --- colitis --- dieet (diëtetiek) --- diverticulitis --- gastro-enterologie (maag-darmziekten) --- gastro-oesofagale reflux (regurgitatie) --- irritable bowel-syndrome --- maagulcus (maagzweer) --- voedingshygiëne (voedingsgewoonten) --- voedingsleer --- Dietary Requirements --- Nutrition Requirements --- Dietary Requirement --- Nutrition Requirement --- Nutritional Requirement --- Requirement, Dietary --- Requirement, Nutrition --- Requirement, Nutritional --- Requirements, Dietary --- Requirements, Nutrition --- Requirements, Nutritional --- Food --- Gastric Feeding Tubes --- Enteral Feeding --- Force Feeding --- Nutrition, Enteral --- Tube Feeding --- Feeding Tube, Gastric --- Feeding Tubes, Gastric --- Feeding, Enteral --- Feeding, Force --- Feeding, Tube --- Feedings, Force --- Force Feedings --- Gastric Feeding Tube --- Tube, Gastric Feeding --- Tubes, Gastric Feeding --- 616.34 Intestines (guts). Bowels. Enteric and gastrointestinal complaints --- Intestines (guts). Bowels. Enteric and gastrointestinal complaints --- Hygiene of nutrition (diet) --- Diëtiek. Voedingsleer. --- Voeding van bijzondere groepen --- (zie ook: voedingshygiëne) --- Gastro-enterologie --- Diëten --- Enteral Nutrition --- Nutritional Requirements --- therapy --- Diëtiek. Voedingsleer --- Sustenance --- Ziekten ; spijsvertering. --- Therapy.

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Pathology --- metabolische ziekten --- stofwisseling --- Nutritionary hygiene. Diet --- voedingstherapie --- klinische voeding --- Enteral Nutrition --- Nutrition --- Parenteral Nutrition --- Metabolism --- Diet therapy --- Parenteral feeding --- Enteral feeding --- Diétothérapie --- Alimentation parentérale --- Alimentation entérale --- Periodicals. --- Périodiques --- Enteral Nutrition. --- Parenteral NutritiondvPeriodicals. --- Metabolism. --- Diet therapy. --- Enteral feeding. --- Nutrition. --- Parenteral feeding. --- Nutritional Physiological Phenomena. --- Parenteral Nutrition. --- Intravenous Feeding --- Nutrition, Parenteral --- Parenteral Feeding --- Feeding, Intravenous --- Feeding, Parenteral --- Feedings, Intravenous --- Feedings, Parenteral --- Intravenous Feedings --- Parenteral Feedings --- Parenteral Nutrition Solutions --- Metabolic Process --- Process, Metabolic --- Processes, Metabolic --- Anabolism --- Catabolism --- Metabolic Processes --- Glycomics --- Metabolome --- Gastric Feeding Tubes --- Enteral Feeding --- Force Feeding --- Nutrition, Enteral --- Tube Feeding --- Feeding Tube, Gastric --- Feeding Tubes, Gastric --- Feeding, Enteral --- Feeding, Force --- Feeding, Tube --- Feedings, Force --- Force Feedings --- Gastric Feeding Tube --- Tube, Gastric Feeding --- Tubes, Gastric Feeding --- Nutrition Phenomena --- Nutrition Physiological Concepts --- Nutrition Physiological Phenomenon --- Nutritional Phenomena --- Nutritional Physiological Phenomenon --- Nutritional Physiology --- Nutritional Physiology Concepts --- Nutritional Physiology Phenomenon --- Nutrition Physiological Phenomena --- Nutrition Physiology --- Nutritional Physiology Phenomena --- Concept, Nutrition Physiological --- Concept, Nutritional Physiology --- Concepts, Nutrition Physiological --- Concepts, Nutritional Physiology --- Nutrition Physiological Concept --- Nutritional Physiology Concept --- Phenomena, Nutrition --- Phenomena, Nutrition Physiological --- Phenomena, Nutritional --- Phenomena, Nutritional Physiological --- Phenomena, Nutritional Physiology --- Phenomenon, Nutrition Physiological --- Phenomenon, Nutritional Physiological --- Phenomenon, Nutritional Physiology --- Physiological Concept, Nutrition --- Physiological Concepts, Nutrition --- Physiological Phenomena, Nutrition --- Physiological Phenomena, Nutritional --- Physiological Phenomenon, Nutrition --- Physiological Phenomenon, Nutritional --- Physiology Concept, Nutritional --- Physiology Concepts, Nutritional --- Physiology Phenomena, Nutritional --- Physiology Phenomenon, Nutritional --- Physiology, Nutrition --- Physiology, Nutritional --- Food --- Nutritional Sciences --- Periodicals --- Health Sciences --- Life Sciences --- General and Others --- Pharmacy and Pharmacology --- Metabolic Phenomenon --- Metabolism Concepts --- Metabolism Phenomena --- Metabolic Concepts --- Metabolic Phenomena --- Concept, Metabolic --- Concept, Metabolism --- Concepts, Metabolic --- Concepts, Metabolism --- Metabolic Concept --- Metabolism Concept --- Phenomena, Metabolic --- Phenomena, Metabolism --- Phenomenon, Metabolic --- Nutrition Process --- Nutritional Process --- Nutritional Processes --- Nutrition Processes --- Process, Nutrition --- Process, Nutritional --- Processes, Nutrition --- Processes, Nutritional --- Phototrophic Processes --- Autotrophic Processes --- Heterotrophic Processes --- Chemoautotrophic Growth --- klinische chemie --- Nutritional Physiological Phenomena

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Nutritional Physiological Phenomena. --- Enteral Nutrition. --- Metabolism. --- Parenteral Nutrition. --- Intravenous Feeding --- Nutrition, Parenteral --- Parenteral Feeding --- Feeding, Intravenous --- Feeding, Parenteral --- Feedings, Intravenous --- Feedings, Parenteral --- Intravenous Feedings --- Parenteral Feedings --- Parenteral Nutrition Solutions --- Metabolic Phenomenon --- Metabolic Process --- Metabolism Concepts --- Metabolism Phenomena --- Process, Metabolic --- Processes, Metabolic --- Anabolism --- Catabolism --- Metabolic Concepts --- Metabolic Phenomena --- Metabolic Processes --- Concept, Metabolic --- Concept, Metabolism --- Concepts, Metabolic --- Concepts, Metabolism --- Metabolic Concept --- Metabolism Concept --- Phenomena, Metabolic --- Phenomena, Metabolism --- Phenomenon, Metabolic --- Gastric Feeding Tubes --- Enteral Feeding --- Force Feeding --- Nutrition, Enteral --- Tube Feeding --- Feeding Tube, Gastric --- Feeding Tubes, Gastric --- Feeding, Enteral --- Feeding, Force --- Feeding, Tube --- Feedings, Force --- Force Feedings --- Gastric Feeding Tube --- Tube, Gastric Feeding --- Tubes, Gastric Feeding --- Nutrition Phenomena --- Nutrition Physiological Concepts --- Nutrition Physiological Phenomenon --- Nutrition Process --- Nutritional Phenomena --- Nutritional Physiological Phenomenon --- Nutritional Physiology --- Nutritional Physiology Concepts --- Nutritional Physiology Phenomenon --- Nutritional Process --- Nutritional Processes --- Nutrition Physiological Phenomena --- Nutrition Physiology --- Nutrition Processes --- Nutritional Physiology Phenomena --- Concept, Nutrition Physiological --- Concept, Nutritional Physiology --- Concepts, Nutrition Physiological --- Concepts, Nutritional Physiology --- Nutrition Physiological Concept --- Nutritional Physiology Concept --- Phenomena, Nutrition --- Phenomena, Nutrition Physiological --- Phenomena, Nutritional --- Phenomena, Nutritional Physiological --- Phenomena, Nutritional Physiology --- Phenomenon, Nutrition Physiological --- Phenomenon, Nutritional Physiological --- Phenomenon, Nutritional Physiology --- Physiological Concept, Nutrition --- Physiological Concepts, Nutrition --- Physiological Phenomena, Nutrition --- Physiological Phenomena, Nutritional --- Physiological Phenomenon, Nutrition --- Physiological Phenomenon, Nutritional --- Physiology Concept, Nutritional --- Physiology Concepts, Nutritional --- Physiology Phenomena, Nutritional --- Physiology Phenomenon, Nutritional --- Physiology, Nutrition --- Physiology, Nutritional --- Process, Nutrition --- Process, Nutritional --- Processes, Nutrition --- Processes, Nutritional --- Food --- Nutritional Sciences --- Phototrophic Processes --- Autotrophic Processes --- Heterotrophic Processes --- Chemoautotrophic Growth --- Periodicals --- Nutritionary hygiene. Diet --- Health Sciences --- Life Sciences --- Medical Education, Training & Research --- Nutrition and Dietetics --- Metabolism --- klinische chemie --- Nutritional Physiological Phenomena --- Enteral Nutrition --- Parenteral Nutrition

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Diet therapy --- Parenteral feeding --- Enteral feeding --- Nutrition --- Nutrition. --- Enteral Nutrition. --- Parenteral Nutrition. --- Diétotherapie --- Alimentation parenterale --- Alimentation enterale --- Diétothérapie --- Alimentation parentérale --- Alimentation entérale --- Diet therapy. --- Enteral feeding. --- Parenteral feeding. --- Enteral Nutrition --- Parenteral Nutrition --- Metabolism --- Intravenous Feeding --- Nutrition, Parenteral --- Parenteral Feeding --- Feeding, Intravenous --- Feeding, Parenteral --- Feedings, Intravenous --- Feedings, Parenteral --- Intravenous Feedings --- Parenteral Feedings --- Gastric Feeding Tubes --- Enteral Feeding --- Force Feeding --- Nutrition, Enteral --- Tube Feeding --- Feeding Tube, Gastric --- Feeding Tubes, Gastric --- Feeding, Enteral --- Feeding, Force --- Feeding, Tube --- Feedings, Force --- Force Feedings --- Gastric Feeding Tube --- Tube, Gastric Feeding --- Tubes, Gastric Feeding --- Intravenous feeding --- Parenteral hyperalimentation --- Parenteral nutrition --- Total parenteral nutrition --- Alimentation --- Food --- Enteral hyperalimentation --- Hyperalimentation, Enteral --- Clinical nutrition --- Diet --- Diet and disease --- Dietotherapy --- Medical nutrition therapy --- MNT (Medical nutrition therapy) --- Nutrition therapy --- Metabolic Phenomenon --- Metabolic Process --- Metabolism Concepts --- Metabolism Phenomena --- Process, Metabolic --- Processes, Metabolic --- Anabolism --- Catabolism --- Metabolic Concepts --- Metabolic Phenomena --- Metabolic Processes --- Concept, Metabolic --- Concept, Metabolism --- Concepts, Metabolic --- Concepts, Metabolism --- Metabolic Concept --- Metabolism Concept --- Phenomena, Metabolic --- Phenomena, Metabolism --- Phenomenon, Metabolic --- Health aspects --- Therapeutic use --- Nutritional Physiological Phenomena --- Diet Therapy --- Diet Modification --- Therapy, Diet --- Dietary Modification --- Diet Modifications --- Diet Therapies --- Dietary Modifications --- Modification, Diet --- Modification, Dietary --- Modifications, Diet --- Modifications, Dietary --- Therapies, Diet --- Disease --- Nutrition Phenomena --- Nutrition Physiological Concepts --- Nutrition Physiological Phenomenon --- Nutrition Process --- Nutritional Phenomena --- Nutritional Physiological Phenomenon --- Nutritional Physiology --- Nutritional Physiology Concepts --- Nutritional Physiology Phenomenon --- Nutritional Process --- Nutritional Processes --- Nutrition Physiological Phenomena --- Nutrition Physiology --- Nutrition Processes --- Nutritional Physiology Phenomena --- Concept, Nutrition Physiological --- Concept, Nutritional Physiology --- Concepts, Nutrition Physiological --- Concepts, Nutritional Physiology --- Nutrition Physiological Concept --- Nutritional Physiology Concept --- Phenomena, Nutrition --- Phenomena, Nutrition Physiological --- Phenomena, Nutritional --- Phenomena, Nutritional Physiological --- Phenomena, Nutritional Physiology --- Phenomenon, Nutrition Physiological --- Phenomenon, Nutritional Physiological --- Phenomenon, Nutritional Physiology --- Physiological Concept, Nutrition --- Physiological Concepts, Nutrition --- Physiological Phenomena, Nutrition --- Physiological Phenomena, Nutritional --- Physiological Phenomenon, Nutrition --- Physiological Phenomenon, Nutritional --- Physiology Concept, Nutritional --- Physiology Concepts, Nutritional --- Physiology Phenomena, Nutritional --- Physiology Phenomenon, Nutritional --- Physiology, Nutrition --- Physiology, Nutritional --- Process, Nutrition --- Process, Nutritional --- Processes, Nutrition --- Processes, Nutritional --- therapeutic use --- diet therapy --- Parenteral Nutrition Solutions --- Artificial feeding --- Parenteral therapy --- Health --- Physiology --- Dietetics --- Digestion --- Food habits --- Malnutrition --- Therapeutics, Physiological --- Nutritional Sciences --- Nutrition Science --- Nutrition Sciences --- Nutritional Science --- Science, Nutrition --- Science, Nutritional --- Sciences, Nutrition --- Sciences, Nutritional --- Food Technology --- Phototrophic Processes --- Autotrophic Processes --- Heterotrophic Processes --- Chemoautotrophic Growth --- Metabolism. --- Nutritional Physiological Phenomena. --- Alimentation parentérale. --- Métabolisme. --- metabolism (biological concept) --- Metabolism, Primary --- Primary metabolism --- Biochemistry --- Dietoteràpia --- Dieta per a malalts --- Revistes --- Malalties i dieta --- Malalts --- Terapèutica --- Terapèutica fisiològica --- Aliments --- Dieta --- Dieta i malaltia --- Nutrició clínica --- Nutrició terapèutica --- Terapèutica dietètica --- Dietètica --- Ús terapèutic