title: Prophylactic versus reactive PEG tube placement in head and neck cancer.
abstract: OBJECTIVE
  To understand the impact of percutaneous endoscopic gastrostomy (PEG) tube placement timing on tube duration, weight loss, and disease control in patients with head and neck cancer (HNC).
  
  
  METHODS
  A tertiary academic center.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Seventy-four patients with HNC were reviewed. Patients underwent cisplatinum-based chemoradiation therapy with or without surgical resection. They received a PEG tube either before radiation therapy began (prophylactic) or after (reactive). Patients were matched on the basis of age, gender, TNM stage, tumor subsite, human papillomavirus (HPV) status, and chemoradiation dose.
  
  
  RESULTS
  Patients receiving reactive PEG tubes had them in place for fewer days than those placed prophylactically (227 vs 139 days, P < .01). There was no difference in percentage weight loss at 2, 6, or 12 months. There was no difference in survival or disease control between the groups.
  
  
  CONCLUSIONS
  Reactive PEG tube placement may afford patients a shorter duration of usage without incurring greater weight loss or poorer oncologic outcomes.
authors.affiliation: College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Kramer
authors.forename: Matthew
authors.initials: M
authors.lastname: Newcomb
authors.forename: Joshua
authors.initials: J
authors.lastname: Hessler
authors.forename: Farzan
authors.initials: F
authors.lastname: Siddiqui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D003680:Deglutition Disorders / Q000209:etiology / Q000517:prevention & control*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: PEG tube; gastrostomy; head and neck cancer; nutrition