{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:17:55Z","timestamp":1792513075984,"version":"4.5.0"},"reference-count":122,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>While surgical therapy for head and neck cancer (HNC) is showing improvement with the advancement of reconstruction techniques, the focus in these patients should also be shifting to supportive pre and aftercare. Due to the highly sensitive and anatomically complex region, these patients tend to exhibit malnutrition, which has a substantial impact on their recovery and quality of life. The complications and symptoms of both the disease and the therapy usually make these patients unable to orally intake food, hence, a strategy should be prepared for their nutritional management. Even though there are several possible nutritional modalities that can be administrated, these patients commonly have a functional gastrointestinal tract, and enteral nutrition is indicated over the parenteral option. However, after extensive research of the available literature, it seems that there is a limited number of studies that focus on this important issue. Furthermore, there are no recommendations or guidelines regarding the nutritional management of HNC patients, pre- or post-operatively. Henceforth, this narrative review summarizes the nutritional challenges and management modalities in this particular group of patients. Nonetheless, this issue should be addressed in future studies and an algorithm should be established for better nutritional care of these patients.<\/jats:p>","DOI":"10.3390\/nu15081864","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T01:35:00Z","timestamp":1681349700000},"page":"1864","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Nutritional Management of Patients with Head and Neck Cancer\u2014A Comprehensive Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-5130","authenticated-orcid":false,"given":"Dinko","family":"Martinovic","sequence":"first","affiliation":[{"name":"Department of Maxillofacial Surgery, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9508-4160","authenticated-orcid":false,"given":"Daria","family":"Tokic","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ema","family":"Puizina Mladinic","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mislav","family":"Usljebrka","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanja","family":"Kadic","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1959-0760","authenticated-orcid":false,"given":"Antonella","family":"Lesin","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5433-5063","authenticated-orcid":false,"given":"Marino","family":"Vilovic","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Slaven","family":"Lupi-Ferandin","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasa","family":"Ercegovic","sequence":"additional","affiliation":[{"name":"Department of Maxillofacial Surgery, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9696-3359","authenticated-orcid":false,"given":"Marko","family":"Kumric","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9316-5538","authenticated-orcid":false,"given":"Josipa","family":"Bukic","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1634-0635","authenticated-orcid":false,"given":"Josko","family":"Bozic","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/0-306-48060-3_2","article-title":"Epidemiology, staging, and screening of head and neck cancer","volume":"114","author":"Argiris","year":"2003","journal-title":"Cancer Treat Res."},{"key":"ref_2","unstructured":"Howlader, N.N.A., Krapcho, M., Miller, D., Brest, A., Yu, M., Ruhl, J., Tatalovich, Z., Mariotto, A., Lewis, D.R., and Chen, H.S. (2023, February 01). EER Cancer Statistics Review, 1975\u20132016, Available online: https:\/\/seer.cancer.gov\/csr\/1975_2016\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1038\/s41572-020-00224-3","article-title":"Head and neck squamous cell carcinoma","volume":"6","author":"Johnson","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"229","DOI":"10.12688\/f1000research.22941.1","article-title":"Oral squamous cell carcinoma: Metastasis, potentially associated malignant disorders, etiology and recent advancements in diagnosis","volume":"9","author":"Bugshan","year":"2020","journal-title":"F1000Research"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Ivkovic, N., Martinovic, D., Kozina, S., Lupi-Ferandin, S., Tokic, D., Usljebrka, M., Kumric, M., and Bozic, J. (2022). Quality of Life and Aesthetic Satisfaction in Patients Who Underwent the \u201cCommando Operation\u201d with Pectoralis Major Myocutaneus Flap Reconstruction-A Case Series Study. Healthcare, 10.","DOI":"10.3390\/healthcare10091737"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/978-3-319-65421-8_11","article-title":"Nutrition Management for the Head and Neck Cancer Patient","volume":"174","author":"Ackerman","year":"2018","journal-title":"Cancer Treat Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2859","DOI":"10.2527\/jas.2010-3649","article-title":"Chemical composition of whole body and carcass of Bos indicus and tropically adapted Bos taurus breeds","volume":"89","author":"Bonilha","year":"2011","journal-title":"J. Anim. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1097\/NCC.0b013e318206b013","article-title":"Comparison of the prevalence of malnutrition diagnosis in head and neck, gastrointestinal, and lung cancer patients by 3 classification methods","volume":"34","author":"Platek","year":"2011","journal-title":"Cancer Nurs."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1136\/pgmj.2005.037564","article-title":"Malnutrition and ageing","volume":"82","author":"Hickson","year":"2006","journal-title":"Postgrad. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1071\/HC10016","article-title":"Weight loss in head and neck cancer patients little noticed in general practice","volume":"2","author":"Merkx","year":"2010","journal-title":"J. Prim. Health Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.bjoms.2011.11.012","article-title":"A review of post-operative feeding in patients undergoing resection and reconstruction for oral malignancy and presentation of a pre-operative scoring system","volume":"50","author":"Eley","year":"2012","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1853","DOI":"10.1016\/j.joms.2013.04.028","article-title":"Nutritional considerations for head and neck cancer patients: A review of the literature","volume":"71","author":"Alshadwi","year":"2013","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1177\/0194599818755995","article-title":"Which Assessment Method of Malnutrition in Head and Neck Cancer?","volume":"158","author":"Saroul","year":"2018","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.clnu.2019.03.030","article-title":"Prevalence and prognostic significance of malnutrition in patients with cancers of the head and neck","volume":"39","author":"Kubrak","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Anderson, G., Ebadi, M., Vo, K., Novak, J., Govindarajan, A., and Amini, A. (2021). An Updated Review on Head and Neck Cancer Treatment with Radiation Therapy. Cancers, 13.","DOI":"10.3390\/cancers13194912"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/00002820-200511000-00004","article-title":"Eating problems and weight loss for patients with head and neck cancer: A chart review from diagnosis until one year after treatment","volume":"28","author":"Larsson","year":"2005","journal-title":"Cancer Nurs."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/S0167-8140(02)00404-8","article-title":"Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: A systematic literature review","volume":"66","author":"Trotti","year":"2003","journal-title":"Radiother. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.rpor.2015.03.001","article-title":"Malnutrition and cachexia in patients with head and neck cancer treated with (chemo)radiotherapy","volume":"20","author":"Gorenc","year":"2015","journal-title":"Rep. Pract. Oncol. Radiother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1097\/01.coc.0000198745.94757.ee","article-title":"Evaluation of Nutritional Status in Cancer Patients Receiving Radiotherapy: A Prospective Study","volume":"29","author":"Unsal","year":"2006","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.radonc.2010.02.017","article-title":"Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer","volume":"97","author":"Langius","year":"2010","journal-title":"Radiother. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2918","DOI":"10.1002\/cam4.1221","article-title":"Common oral complications of head and neck cancer radiation therapy: Mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis","volume":"6","author":"Sroussi","year":"2017","journal-title":"Cancer Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"090","DOI":"10.1016\/j.ijrobp.2009.06.090","article-title":"Radiotherapy dose-volume effects on salivary gland function","volume":"76","author":"Deasy","year":"2010","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s00520-015-2823-5","article-title":"Radiotherapy-induced xerostomia, pre-clinical promise of LMS-611","volume":"24","author":"Paterson","year":"2016","journal-title":"Support Care Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Bozzetti, F., and Cotogni, P. (2020). Nutritional Issues in Head and Neck Cancer Patients. Healthcare, 8.","DOI":"10.3390\/healthcare8020102"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1080\/01635581.2013.741749","article-title":"More than 10% weight loss in head and neck cancer patients during radiotherapy is independently associated with deterioration in quality of life","volume":"65","author":"Langius","year":"2013","journal-title":"Nutr. Cancer"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.oraloncology.2014.06.009","article-title":"Nutrition impact symptoms in a population cohort of head and neck cancer patients: Multivariate regression analysis of symptoms on oral intake, weight loss and survival","volume":"50","author":"Farhangfar","year":"2014","journal-title":"Oral Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1097\/00075197-200207000-00013","article-title":"Preoperative nutritional support at home in head and neck cancer patients: From nutritional benefits to the prevention of the alcohol withdrawal syndrome","volume":"5","author":"Bertrand","year":"2002","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1177\/019459989110500109","article-title":"Prognostic factors in advanced head and neck cancer patients undergoing multimodality therapy","volume":"105","author":"Mick","year":"1991","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.1016\/j.clnu.2021.02.005","article-title":"ESPEN practical guideline: Clinical Nutrition in cancer","volume":"40","author":"Muscaritoli","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_31","first-page":"127","article-title":"A Better Journey for Patients, a Better Deal for the NHS: The Successful Implementation of an Enhanced Recovery Program after Renal Transplant Surgery","volume":"16","author":"Halawa","year":"2018","journal-title":"Exp. Clin. Transpl."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1053\/j.gastro.2008.10.030","article-title":"A fast-track program reduces complications and length of hospital stay after open colonic surgery","volume":"136","author":"Muller","year":"2009","journal-title":"Gastroenterology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1001\/jamaoto.2016.2981","article-title":"Optimal Perioperative Care in Major Head and Neck Cancer Surgery with Free Flap Reconstruction: A Consensus Review and Recommendations from the Enhanced Recovery after Surgery Society","volume":"143","author":"Dort","year":"2017","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2473974X211021100","DOI":"10.1177\/2473974X211021100","article-title":"Enhanced Recovery after Surgery Nutrition Protocol for Major Head and Neck Cancer Surgery","volume":"5","author":"Moore","year":"2021","journal-title":"OTO Open"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1097\/00004836-200304000-00004","article-title":"Enteral nutritional support of the patient with cancer: Route and role","volume":"36","author":"Schattner","year":"2003","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1002\/1097-0142(20010501)91:9<1785::AID-CNCR1197>3.0.CO;2-1","article-title":"Enteral nutrition during the treatment of head and neck carcinoma: Is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube?","volume":"91","author":"Mekhail","year":"2001","journal-title":"Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1046\/j.1365-2354.1999.00156.x","article-title":"Incidence of weight loss in head and neck cancer patients on commencing radiotherapy treatment at a regional oncology centre","volume":"8","author":"Lees","year":"1999","journal-title":"Eur. J. Cancer Care"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1080\/00016489.2016.1277263","article-title":"Cachexia at diagnosis is associated with poor survival in head and neck cancer patients","volume":"137","author":"Saarilahti","year":"2017","journal-title":"Acta Otolaryngol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"827","DOI":"10.3389\/fonc.2019.00827","article-title":"Diagnostic Tumor Markers in Head and Neck Squamous Cell Carcinoma (HNSCC) in the Clinical Setting","volume":"9","author":"Economopoulou","year":"2019","journal-title":"Front. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.jand.2016.10.013","article-title":"Comparison of Nutritional and Clinical Outcomes in Patients with Head and Neck Cancer Undergoing Chemoradiotherapy Utilizing Prophylactic versus Reactive Nutrition Support Approaches","volume":"118","author":"Brown","year":"2018","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1001\/archotol.124.5.589","article-title":"Eating and weight changes following chemoradiation therapy for advanced head and neck cancer","volume":"124","author":"Newman","year":"1998","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1067\/mhn.2001.120428","article-title":"Predictors of weight loss during radiation therapy","volume":"125","author":"Beaver","year":"2001","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Doley, J. (2022). Enteral Nutrition Overview. Nutrients, 14.","DOI":"10.3390\/nu14112180"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1016\/j.anorl.2019.01.001","article-title":"Malnutrition in head and neck cancer patients: Impacts and indications of a prophylactic percutaneous endoscopic gastrostomy","volume":"136","author":"Yanni","year":"2019","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/hed.21700","article-title":"Impact of prophylactic percutaneous endoscopic gastrostomy on malnutrition and quality of life in patients with head and neck cancer: A randomized study","volume":"34","author":"Silander","year":"2012","journal-title":"Head Neck"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1002\/hed.21624","article-title":"Impact of early percutaneous endoscopic gastrostomy tube placement on nutritional status and hospitalization in patients with head and neck cancer receiving definitive chemoradiation therapy","volume":"33","author":"Rutter","year":"2011","journal-title":"Head Neck"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.radonc.2009.05.016","article-title":"Impact of the prophylactic gastrostomy for unresectable squamous cell head and neck carcinomas treated with radio-chemotherapy on quality of life: Prospective randomized trial","volume":"93","author":"Salas","year":"2009","journal-title":"Radiother. Oncol."},{"key":"ref_48","first-page":"757","article-title":"Safety and efficacy of pretreatment placement of PEG tubes in head and neck cancer patients undergoing chemoradiation treatment","volume":"23","author":"Raykher","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.suronc.2006.12.002","article-title":"Safety and effectiveness of prophylactic gastrostomy tubes for head and neck cancer patients undergoing chemoradiation","volume":"15","author":"Nguyen","year":"2006","journal-title":"Surg. Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1207\/s15327914nc5001_6","article-title":"Percutaneous endoscopic gastrostomy for long-term feeding of patients with oropharyngeal tumors","volume":"50","author":"Anwander","year":"2004","journal-title":"Nutr. Cancer"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4997\/JRCPE.2015.112","article-title":"Enteral tube feeding in adults","volume":"45","author":"Scott","year":"2015","journal-title":"J. R. Coll. Physicians Edinb."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-S\u00e1nchez, E., Ruano-\u00c1lvarez, M.A., D\u00edaz-Jim\u00e9nez, J., D\u00edaz, A.J., and Ordonez, F.J. (2021). Enteral Nutrition by Nasogastric Tube in Adult Patients under Palliative Care: A Systematic Review. Nutrients, 13.","DOI":"10.3390\/nu13051562"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"265","DOI":"10.3390\/nu7010265","article-title":"Nutritional interventions in head and neck cancer patients undergoing chemoradiotherapy: A narrative review","volume":"7","author":"Bossola","year":"2015","journal-title":"Nutrients"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.clnu.2006.01.020","article-title":"ESPEN Guidelines on Enteral Nutrition: Non-surgical oncology","volume":"25","author":"Arends","year":"2006","journal-title":"Clin. Nutr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"596","DOI":"10.6004\/jnccn.2011.0053","article-title":"Head and neck cancers","volume":"9","author":"Pfister","year":"2011","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.clnu.2013.06.012","article-title":"Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: A systematic review","volume":"32","author":"Langius","year":"2013","journal-title":"Clin. Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1002\/jpen.2360","article-title":"Tube feeding in patients with head and neck cancer undergoing chemoradiotherapy: A systematic review","volume":"46","author":"Bossola","year":"2022","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"512","DOI":"10.20960\/nh.680","article-title":"Gastrostomy vs nasogastric tube feeding in patients with head and neck cancer during radiotherapy alone or combined chemoradiotherapy","volume":"34","author":"Soria","year":"2017","journal-title":"Nutr. Hosp."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/j.1440-1673.2008.02003.x","article-title":"Randomized study of percutaneous endoscopic gastrostomy versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo)radiation","volume":"52","author":"Corry","year":"2008","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1002\/jpen.2267","article-title":"Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition","volume":"46","author":"Compher","year":"2022","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1177\/0115426502017005275","article-title":"Ins and outs of enteral access. Part 1: Short-term enteral access","volume":"17","author":"Vanek","year":"2002","journal-title":"Nutr. Clin. Pract."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1177\/0148607108330314","article-title":"Enteral nutrition practice recommendations","volume":"33","author":"Bankhead","year":"2009","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1177\/0148607114522487","article-title":"A tutorial on enteral access in adult patients in the hospitalized setting","volume":"38","author":"Miller","year":"2014","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1177\/011542650602100140","article-title":"Acute complications associated with bedside placement of feeding tubes","volume":"21","author":"Baskin","year":"2006","journal-title":"Nutr. Clin. Pract."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1177\/0148607111413898","article-title":"Pulmonary complications of 9931 narrow-bore nasoenteric tubes during blind placement: A critical review","volume":"35","author":"Sparks","year":"2011","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1177\/0884533615594012","article-title":"Enteral Nutrition for Adults in the Hospital Setting","volume":"30","author":"Kozeniecki","year":"2015","journal-title":"Nutr. Clin. Pract."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1177\/0148607115575034","article-title":"Use of an Electromagnetic Device Compared with Chest X-ray to Confirm Nasogastric Feeding Tube Position in Critical Care","volume":"40","author":"Bear","year":"2016","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1177\/0148607109354781","article-title":"Jejunal feeding tubes can be efficiently and independently placed by intensive care unit teams","volume":"34","author":"Welpe","year":"2010","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1177\/0884533612462239","article-title":"Feeding tube placement: Errors and complications","volume":"27","author":"Stayner","year":"2012","journal-title":"Nutr. Clin. Pract."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1177\/0884533615595593","article-title":"Risk-Benefit Profile of Gastric vs Transpyloric Feeding in Mechanically Ventilated Patients: A Meta-Analysis","volume":"31","author":"Li","year":"2016","journal-title":"Nutr. Clin. Pract."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1177\/0884533608314535","article-title":"Transnasal endoscopic placement of nasoenteric feeding tubes: Outcomes and limitations in non-critically ill patients","volume":"23","author":"Mahadeva","year":"2008","journal-title":"Nutr. Clin. Pract."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/0148607116673053","article-title":"ASPEN Safe Practices for Enteral Nutrition Therapy [Formula: See text]","volume":"41","author":"Boullata","year":"2017","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_73","first-page":"529","article-title":"Percutaneous endoscopic gastrostomy: An update on its indications, management, complications, and care","volume":"106","author":"Lucendo","year":"2014","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/S0016-5107(03)02147-3","article-title":"Complications of enteral access","volume":"58","author":"McClave","year":"2003","journal-title":"Gastrointest. Endosc."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"7739","DOI":"10.3748\/wjg.v20.i24.7739","article-title":"Percutaneous endoscopic gastrostomy: Indications, technique, complications and management","volume":"20","author":"Rahnemaiazar","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/S0901-5027(05)80693-9","article-title":"Percutaneous endoscopic gastrostomy for postoperative rehabilitation after maxillofacial tumor surgery","volume":"20","author":"Koehler","year":"1991","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1097\/SPC.0b013e32835999d5","article-title":"The role of dietary counseling and nutrition support in head and neck cancer patients","volume":"6","author":"Platek","year":"2012","journal-title":"Curr. Opin. Support Palliat. Care"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1002\/hed.23426","article-title":"Toxicities and costs of placing prophylactic and reactive percutaneous gastrostomy tubes in patients with locally advanced head and neck cancers treated with chemoradiotherapy","volume":"36","author":"Baschnagel","year":"2014","journal-title":"Head Neck"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1007\/s002709900269","article-title":"Percutaneous radiologic, surgical endoscopic, and percutaneous endoscopic gastrostomy\/gastrojejunostomy: Comparative study and cost analysis","volume":"21","author":"Barkmeier","year":"1998","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/S0009-9260(03)00058-8","article-title":"Gastrostomy insertion: Comparing the options\u2014PEG, RIG or PIG?","volume":"58","author":"Laasch","year":"2003","journal-title":"Clin. Radiol."},{"key":"ref_81","unstructured":"Sigmon, D.F., and An, J. (2022). StatPearls, StatPearls Publishing LLC."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3109\/00365529209096035","article-title":"Feeding via nasogastric tube or percutaneous endoscopic gastrostomy. A comparison","volume":"194","author":"Baeten","year":"1992","journal-title":"Scand. J. Gastroenterol. Suppl."},{"key":"ref_83","first-page":"147","article-title":"Percutaneous endoscopic gastrostomy in patients with prior abdominal surgery: Virtues of the safe tract","volume":"83","author":"Foutch","year":"1988","journal-title":"Am. J. Gastroenterol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1177\/0148607110376197","article-title":"Predictive factors of mortality after PEG insertion: Guidance for clinical practice","volume":"35","author":"Zopf","year":"2011","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1046\/j.1365-2036.2003.01684.x","article-title":"Antibiotic prophylaxis for percutaneous endoscopic gastrostomy--a prospective, randomised, double-blind trial","volume":"18","author":"Ahmad","year":"2003","journal-title":"Aliment. Pharm."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1136\/gut.2007.136580","article-title":"Antibiotic prophylaxis in gastrointestinal endoscopy","volume":"58","author":"Allison","year":"2009","journal-title":"Gut"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.12968\/bjon.2012.21.Sup3.S14","article-title":"Managing overgranulation tissue around gastrostomy sites","volume":"21","author":"Warriner","year":"2012","journal-title":"Br. J. Nurs."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1097\/00042737-200107000-00010","article-title":"Percutaneous endoscopic gastrostomy: Complications and suggestions to avoid them","volume":"13","author":"Schurink","year":"2001","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/S0379-0738(00)00366-2","article-title":"Fatal retroperitoneal haemorrhage: An unusual complication of percutaneous endoscopic gastrostomy","volume":"116","author":"Lau","year":"2001","journal-title":"Forensic. Sci. Int."},{"key":"ref_90","first-page":"448","article-title":"The \u201cburied bumper syndrome\u201d: A complication of percutaneous endoscopic gastrostomy","volume":"85","author":"Klein","year":"1990","journal-title":"Am. J. Gastroenterol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1177\/0148607101025005282","article-title":"Metastasis of head and neck carcinoma to the site of percutaneous endoscopic gastrostomy: Case report and literature review","volume":"25","author":"Sinclair","year":"2001","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"3288","DOI":"10.1111\/j.1572-0241.2000.03339.x","article-title":"Cancer metastasis at percutaneous endoscopic gastrostomy stomata is related to the hematogenous or lymphatic spread of circulating tumor cells","volume":"95","author":"Brown","year":"2000","journal-title":"Am. J. Gastroenterol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S1051-0443(99)70058-8","article-title":"Radiologic gastrojejunostomy and percutaneous endoscopic gastrostomy: A prospective, randomized comparison","volume":"10","author":"Hoffer","year":"1999","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1148\/radiology.203.2.9114111","article-title":"Percutaneous gastrostomy with T-fastener gastropexy: Results of 316 consecutive procedures","volume":"203","author":"Ryan","year":"1997","journal-title":"Radiology"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.crad.2012.01.014","article-title":"Multicentre survey of radiologically inserted gastrostomy feeding tube (RIG) in the UK","volume":"67","author":"Lowe","year":"2012","journal-title":"Clin. Radiol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"S25","DOI":"10.5009\/gnl.2010.4.S1.S25","article-title":"Updates on percutaneous radiologic gastrostomy\/gastrojejunostomy and jejunostomy","volume":"4","author":"Shin","year":"2010","journal-title":"Gut Liver"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1053\/crad.2001.0782","article-title":"Radiological percutaneous gastrostomy","volume":"56","author":"Ho","year":"2001","journal-title":"Clin. Radiol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1111\/1754-9485.12932","article-title":"Outcomes of radiologically inserted gastrostomy versus percutaneous endoscopic gastrostomy","volume":"63","author":"Cherian","year":"2019","journal-title":"J. Med. Imaging Radiat. Oncol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1148\/radiology.197.3.7480742","article-title":"Radiologic, endoscopic, and surgical gastrostomy: An institutional evaluation and meta-analysis of the literature","volume":"197","author":"Wollman","year":"1995","journal-title":"Radiology"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"116622","DOI":"10.1016\/j.jns.2019.116622","article-title":"Technical success rate and safety of radiologically inserted gastrostomy versus percutaneous endoscopic gastrostomy in motor neuron disease patients undergoing: A systematic review and meta-analysis","volume":"410","author":"Yuan","year":"2020","journal-title":"J. Neurol. Sci."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1590\/S0100-69912013000600007","article-title":"Surgical gastrostomy: Current indications and complications in a university hospital","volume":"40","author":"Anselmo","year":"2013","journal-title":"Rev. Col. Bras. Cir."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1006\/jsre.1995.1001","article-title":"Laparoscopic gastrostomy: A safe method for obtaining enteral access","volume":"58","author":"Murayama","year":"1995","journal-title":"J. Surg. Res."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"169","DOI":"10.6061\/clinics\/2016(03)09","article-title":"Percutaneous endoscopic versus surgical gastrostomy in patients with benign and malignant diseases: A systematic review and meta-analysis","volume":"71","author":"Bravo","year":"2016","journal-title":"Clinics"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"27","DOI":"10.5223\/pghn.2017.20.1.27","article-title":"Comparison of Percutaneous Endoscopic Gastrostomy and Surgical Gastrostomy in Severely Handicapped Children","volume":"20","author":"Kim","year":"2017","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_105","first-page":"3","article-title":"Jejunostomy-technique and controversies","volume":"5","author":"Bakhos","year":"2019","journal-title":"J. Vis. Surg."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1097\/00005373-199912000-00004","article-title":"Complications of surgical feeding jejunostomy in trauma patients","volume":"47","author":"Holmes","year":"1999","journal-title":"J. Trauma"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0002-9610(99)80013-0","article-title":"Complications of needle catheter jejunostomy in 2,022 consecutive applications","volume":"170","author":"Myers","year":"1995","journal-title":"Am. J. Surg."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"45","DOI":"10.4997\/JRCPE.2015.111","article-title":"Parenteral nutrition","volume":"45","author":"Inayet","year":"2015","journal-title":"J. R. Coll. Physicians Edinb."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1177\/0115426505020006625","article-title":"Review of the refeeding syndrome","volume":"20","author":"Kraft","year":"2005","journal-title":"Nutr. Clin. Pract."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s13054-018-1939-7","article-title":"Supplemental parenteral nutrition versus usual care in critically ill adults: A pilot randomized controlled study","volume":"22","author":"Ridley","year":"2018","journal-title":"Crit. Care"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"527","DOI":"10.4103\/apjon.apjon-2145","article-title":"Understanding Cachexia in Head and Neck Cancer","volume":"8","author":"Muthanandam","year":"2021","journal-title":"Asia Pac. J. Oncol. Nurs."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1007\/s12325-022-02074-9","article-title":"Managing Cachexia in Head and Neck Cancer: A Systematic Scoping Review","volume":"39","author":"Alabi","year":"2022","journal-title":"Adv. Ther."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/ctr.12161","article-title":"Indications for intestinal transplantation: Recognizing the scope and limits of total parenteral nutrition","volume":"25","author":"Gotthardt","year":"2013","journal-title":"Clin. Transpl."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/S0377-1237(17)30942-5","article-title":"Total Parenteral Nutrition","volume":"51","author":"Maudar","year":"1995","journal-title":"Med. J. Armed Forces India"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/0019-5049.63637","article-title":"Parenteral nutrition: Revisited","volume":"54","author":"Chowdary","year":"2010","journal-title":"Indian J. Anaesth."},{"key":"ref_116","first-page":"000069","article-title":"Surgery and transplantation\u2014Guidelines on Parenteral Nutrition, Chapter 18","volume":"18","author":"Weimann","year":"2009","journal-title":"Ger. Med. Sci."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/j.athoracsur.2011.10.060","article-title":"Postesophagectomy chylothorax: Incidence, risk factors, and outcomes","volume":"93","author":"Shah","year":"2012","journal-title":"Ann. Thorac. Surg."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1177\/0148607102026004248","article-title":"Enteral versus parenteral nutrition: The patient\u2019s preference","volume":"26","author":"Scolapio","year":"2002","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1177\/0148607111420157","article-title":"Clinical Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients: Applying the GRADE system to development of A.S.P.E.N. clinical guidelines","volume":"36","author":"Druyan","year":"2012","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1007\/s00455-009-9213-4","article-title":"Clinical outcomes comparing parenteral and nasogastric tube nutrition after laryngeal and pharyngeal cancer surgery","volume":"24","author":"Ryu","year":"2009","journal-title":"Dysphagia"},{"key":"ref_121","first-page":"11","article-title":"Refeeding syndrome: An important aspect of supportive oncology","volume":"7","author":"Marinella","year":"2009","journal-title":"J. Support Oncol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.clnu.2009.04.002","article-title":"ESPEN Guidelines on Parenteral Nutrition: Surgery","volume":"28","author":"Braga","year":"2009","journal-title":"Clin. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/8\/1864\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:15:09Z","timestamp":1760123709000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/8\/1864"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,13]]},"references-count":122,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["nu15081864"],"URL":"https:\/\/doi.org\/10.3390\/nu15081864","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,13]]}}}