title: Impact of early percutaneous endoscopic gastrostomy tube placement on nutritional status and hospitalization in patients with head and neck cancer receiving definitive chemoradiation therapy.
abstract: BACKGROUND
  This study analyzed the impact of timing of percutaneous endoscopic gastrostomy (PEG) tube placement on clinical endpoints in patients undergoing concurrent chemoradiation therapy (CRT).
  
  
  METHODS
  In all, 111 patients who underwent CRT for locally advanced squamous cell carcinoma of the head and neck (SCCHN) were retrospectively analyzed to determine the effect of timing of PEG placement on weight loss, hospitalizations, and rates of PEG complications/dependence.
  
  
  RESULTS
  Early PEG tube placement was correlated to reductions in weight loss during CRT (p < .001, R = 0.495), hospitalization for nutritional deficits (p = .011, R = 0.262), and magnitude of persistent weight loss at 6 weeks post-CRT (p = .003, R = 0.347). Disease control was the only predictor of PEG dependence. No differences were seen in PEG complication or dependence rates with earlier placement.
  
  
  CONCLUSIONS
  The results of our series show that patients with locally advanced SCCHN undergoing definitive CRT may derive significant clinical benefit from the early placement of PEG tubes for nutritional supplementation.
authors.affiliation: University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Rutter
authors.forename: Susannah
authors.initials: S
authors.lastname: Yovino
authors.forename: Rodney
authors.initials: R
authors.lastname: Taylor
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wolf
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Cullen
authors.forename: Robert
authors.initials: R
authors.lastname: Ord
authors.forename: Mindy
authors.initials: M
authors.lastname: Athas
authors.forename: Ann
authors.initials: A
authors.lastname: Zimrin
authors.forename: Scott
authors.initials: S
authors.lastname: Strome
authors.forename: Mohan
authors.initials: M
authors.lastname: Suntharalingam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy; D059248:Chemoradiotherapy; D018450:Disease Progression; D016099:Endoscopy, Gastrointestinal; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000517:prevention & control; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009752:Nutritional Status; D012044:Regression Analysis; D012189:Retrospective Studies; D015431:Weight Loss