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Keywords:

  • percutaneous endoscopic gastrostomy tube;
  • nasogastric tube;
  • head and neck cancer;
  • chemoradiation

Abstract

Background

Percutaneous endoscopic gastrostomy (PEG) tubes have largely replaced nasogastric tubes (NGTs) for nutritional support of patients with head and neck cancer undergoing curative (chemo) radiotherapy without any good scientific basis.

Methods

A prospective study was conducted to compare PEG tubes and NGTs in terms of nutritional outcomes, complications, patient satisfaction, and cost.

Results

There were 32 PEG and 73 NGT patients. PEG patients sustained significantly less weight loss at 6 weeks post-treatment (median 0.8 kg gain vs 3.7 kg loss, p < .001), but had a high insertion site infection rate (41%), longer median duration of use (146 vs 57 days, p < .001), and more grade 3 dysphagia in disease-free survivors at 6 months (25% vs 8%, p = .07). Patient self-assessed general physical condition and overall quality of life scores were similar in both groups. Overall costs were significantly higher for PEG patients.

Conclusion

PEG tube use should be selective, not routine, in this patient population. © 2009 Wiley Periodicals, Inc. Head Neck, 2009