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


CONCLUSIONS
PEG tube use should be selective, not routine, in this patient population.
Corry
June
J
Division of Radiation Oncology, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Australia. june.corry@petermac.org
Poon
Wendy
W
McPhee
Narelle
N
Milner
Alvin D
AD
Cruickshank
Deborah
D
Porceddu
Sandro V
SV
Rischin
Danny
D
Peters
Lester J
LJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult