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Published on: April 20, 2018
Prophylactic versus reactive PEG tube placement in head and neck cancer
Scott Kramer1, Matthew Newcomb, Joshua Hessler
1College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
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).
Setting:
A tertiary academic center.
Study Design:
Historical cohort study.
Subjects And 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.
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