Effect of prophylactic percutaneous endoscopic gastrostomy tube on swallowing in advanced head and neck cancer: A randomized controlled study.
Dysphagia is common in head and neck cancer. A percutaneous endoscopic gastrostomy (PEG) tube is used to facilitate nutrition; however, some retrospective studies have indicated that the PEG tube causes dysphagia.



A randomized study of patients with head and neck cancer was conducted with up to 10 years of follow-up. Patients were randomized to either the prophylactic PEG tube group (study group) or the common clinical nutritional support group (control group). At each follow-up, a dietician assessed the oral intake, noted the patients' weight, and if the patients used a PEG tube. Dysphagia was also assessed by the quality of life questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Head and Neck 35-questions (EORTC-QLQ-H&N35).



One hundred thirty-four patients were included in this study. There was no significant difference in swallowing function between the groups after 12 months, 24 months, and 8 years based on the EORTC-QLQ-H&N35, the oral intake scale, tube dependence, esophageal intervention, weight, body mass index (BMI), and overall survival.



A prophylactic PEG tube can be used without an increased risk of long-term dysphagia in patients with head and neck cancer. © 2017 Wiley Periodicals, Inc. Head Neck 39: 908-915, 2017.
Department of Otorhinolaryngology - Head and Neck Surgery, University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
Lars
L
Axelsson
Department of Otorhinolaryngology - Head and Neck Surgery, University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
Ewa
E
Silander
Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden.
Jan
J
Nyman
Department of Otorhinolaryngology, NU Hospital Group, Trollhättan, Sweden.
Mogens
M
Bove
Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden.
Leif
L
Johansson
Department of Otorhinolaryngology - Head and Neck Surgery, University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.
Eva
E
Hammerlid
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000517:prevention & control*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000517:prevention & control*; D008875:Middle Aged; D018529:Nutritional Support; D011183:Postoperative Complications / Q000517:prevention & control*; D015996:Survival Rate
dysphagia; head and neck cancer; percutaneous endoscopic gastrostomy; randomized controlled study; swallowing function