title: Early percutaneous endoscopic gastrostomy insertion maintains nutritional state in patients with aerodigestive tract cancer.
abstract: Patients with upper aerodigestive tract (UAT) cancers often suffer from malnutrition and compromised functional ability. We compared clinical outcome with percutaneous endoscopic gastrostomy (PEG) tube feeding begun at two different time points. The records of 151 patients with UAT carcinomas were reviewed retrospectively. We included patients undergoing radical radiochemotherapy and PEG tube feeding. Subjects were evaluated before PEG insertion and at the end of the treatment. Patients (n=15, 100%) were divided into two groups according to the presence (group A) or absence (group B) of mucositis. Group A (51.7% of patients) received early PEG: before or within 2 wk of radiotherapy. Group B (48.3%) received delayed PEG: between 2 wk and 3 mo after the start of radiotherapy. Mean weight loss was 1.03 kg in group A vs. 4.0 kg in group B, P=0.004. Treatment interruptions were significantly (P=0.01) more common in group B. Early PEG placement at the beginning of radiochemotherapy in patients with UAT tumors maintains the patient's nutritional state and reduces treatment interruptions.
authors.affiliation: Department of Radiation Oncology, University Hospital, Bern, Switzerland.
authors.forename: Karl T
authors.initials: KT
authors.lastname: Beer
authors.forename: Kerstin B
authors.initials: KB
authors.lastname: Krause
authors.forename: Theres
authors.initials: T
authors.lastname: Zuercher
authors.forename: Zeno
authors.initials: Z
authors.lastname: Stanga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D004724:Endoscopy / Q000379:methods; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000379:methods; D006258:Head and Neck Neoplasms / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000517:prevention & control; D008875:Middle Aged; D052016:Mucositis / Q000150:complications / Q000209:etiology; D009752:Nutritional Status; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss