Journal of radiation research
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Review Meta Analysis Comparative Study
Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer: a systematic review.
There are two main enteral feeding strategies-namely nasogastric (NG) tube feeding and percutaneous gastrostomy-used to improve the nutritional status of patients with head and neck cancer (HNC). But up till now there has been no consistent evidence about which method of enteral feeding is the optimal method for this patient group. To compare the effectiveness of percutaneous gastrostomy and NGT feeding in patients with HNC, relevant literature was identified through Medline, Embase, Pubmed, Cochrane, Wiley and manual searches. ⋯ Data were then compared with respect to nutritional status, duration of feeding, complications, radiotherapy delays, disease-free survival and overall survival. Methodological quality of RCTs and non-experimental studies were assessed with separate standard grading scales. It became apparent from our studies that both feeding strategies have advantages and disadvantages.
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By adopting the concept of scientific paradigm after L. Sagan, the history of paradigm shift in 1950 in radiation protection standard by ICRP from a threshold to a non-threshold model was critically reviewed. ⋯ We can find some motives for another shift among these controversies now. It is the purpose of the present review to stimulate the discussion on a possible new paradigm.