Prospective study of percutaneous endoscopic gastrostomy tubes versus nasogastric tubes for enteral feeding in patients with head and neck cancer undergoing (chemo)radiation

Authors

  • June Corry FRANZCR,

    Corresponding author
    1. Division of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
    2. University of Melbourne, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
    • Division of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
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  • Wendy Poon BSc(Nursing),

    1. Division of Nursing, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
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  • Narelle McPhee BSc(Dietitian),

    1. Nutrition Department, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
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  • Alvin D. Milner PhD,

    1. Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
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  • Deborah Cruickshank BA(Hons),

    1. Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
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  • Sandro V. Porceddu FRANZCR,

    1. Division of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
    2. Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, Brisbane, Australia
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  • Danny Rischin FRACP,

    1. University of Melbourne, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
    2. Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
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  • Lester J. Peters FRANZCR

    1. Division of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
    2. University of Melbourne, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia
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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

Ancillary