title: Swallowing outcomes and PEG dependence in head and neck cancer patients receiving definitive or adjuvant radiotherapy +/- chemotherapy with a proactive PEG: a prospective study with long term follow up.
abstract: OBJECTIVE
  This study examined long term swallowing outcomes of a cohort of head and neck cancer (HNC) patients identified at high risk of experiencing significant side effects from cancer treatment and were provided with a proactive PEG.
  
  
  METHODS
  Ninety-five HNC patients receiving definitive or adjuvant radiotherapy +/- chemotherapy were identified for proactive PEG placement using validated guidelines and followed for up to 3years. Functional swallowing status was recorded at regular time points and data were collected on PEG use and duration in situ.
  
  
  RESULTS
  Mean duration of enteral feeding was 125days. PEGs remained in situ for approximately 7months. PEG removal was achieved by 52% by 6months and 86% by 1year. Only 3 (3%) remained PEG dependent at 3years. Over half (55%) had resumed a full non-texture modified diet by PEG removal.
  
  
  CONCLUSIONS
  Proactive PEG placement did not lead to high proportion of long term tube dependence in this high risk group and the majority achieved good swallowing outcomes.
authors: Royal Brisbane & Women's Hospital, Metro North Hospital and Health Service, Australia. Electronic address: Janecrombie1@gmail.com.
authors: Jane M
authors: JM
authors: Crombie
authors: School of Health & Rehabilitation Sciences, The University of Queensland, Australia.
authors: Stephanie
authors: S
authors: Ng
authors: Royal Brisbane & Women's Hospital, Metro North Hospital and Health Service, Australia.
authors: Ann-Louise
authors: AL
authors: Spurgin
authors: School of Health & Rehabilitation Sciences, The University of Queensland, Australia; Centre for Functioning and Health Research, Metro South Hospital and Health Service, Australia.
authors: Elizabeth C
authors: EC
authors: Ward
authors: Royal Brisbane & Women's Hospital, Metro North Hospital and Health Service, Australia.
authors: Teresa E
authors: TE
authors: Brown
authors: Royal Brisbane & Women's Hospital, Metro North Hospital and Health Service, Australia; School of Medicine, The University of Queensland, Australia.
authors: Brett G M
authors: BG
authors: Hughes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000209:etiology*; D004750:Enteral Nutrition / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000150:complications / Q000628:therapy; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000517:prevention & control*; D008875:Middle Aged; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cancer; Chemoradiotherapy; PEG; Proactive; Radiotherapy; Swallowing