Department of Neurology, Eighth People's Hospital of Hebei Province, Shijiazhuang, 050011, China , zhaojing820714@163.com
Abstract: (16 Views)
Background:Gastroesophageal reflux (GER) is a common complication after radiotherapy, potentially influenced by changes in esophageal sphincter pressure and nutrition tube placement. To investigate the relationship between Nas jejunal-gastric (NG-J) tube application and abnormal esophageal sphincter pressure in elderly patients with GER after radiotherapy. Materials and Methods: A prospective observational study was conducted on elderly patients with confirmed GER who underwent external beam radiotherapy for thoracic or head-and-neck malignancies between 2022 and 2024. Radiotherapy was delivered using intensity-modulated radiotherapy (IMRT) with a total dose of 50-70 Gy in daily fractions of 1.8-2.0 Gy. Esophageal manometry was performed before and within 1 month after radiotherapy. Patients requiring NG-J tube feeding were compared to those without tube placement. Results: Among 86 patients, 38 received NG-J tube feeding and 48 did not. Post-radiotherapy, the NG-J tube group showed a significantly greater reduction in lower esophageal sphincter pressure (-12.4 ± 3.2 mmHg vs. -6.8 ± 2.9 mmHg, p<0.001) and a higher incidence of severe GER symptoms (63.2% vs. 33.3%, p=0.005). Radiation dose to the lower esophagus (>60 Gy) correlated with a greater decline in sphincter pressure (r = -0.58, p<0.001). Conclusion: NG-J tube application in elderly patients after high-dose radiotherapy is associated with more pronounced reductions in esophageal sphincter pressure and increased GER severity. Careful tube management and minimizing esophageal radiation exposure may reduce complications.