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Prophylactic gastrostomy placement and early tube feeding may limit loss of weight during chemoradiotherapy for advanced head and neck cancer, a preliminary study.
Clin Otolaryngol. 2007 Oct; 32(5):384-90.CO

Abstract

OBJECTIVES

Most patients with advanced head and neck cancer receiving chemoradiotherapy need tube feeding for at least some weeks. For these periods gastrostomy tubes have advantages over nasogastric tubes. Tube feeding may start earlier and thus loss of weight may be limited if the gastrostomy tube already is in place. The objective of this study is to analyse the results of prophylactic percutaneous endoscopic gastrostomy (PEG) tube placement and early tube feeding.

DESIGN

Retrospective chart review.

SETTING

Multidisciplinary head and neck oncology team in a general hospital.

PARTICIPANTS

Fifty consecutive patients with unresectable stage III and IV head and neck cancer treated with concurrent chemoradiotherapy. In all patients prophylactic PEG placement was performed. Tube feeding was initiated if food-intake became insufficient or loss of weight occurred.

MAIN OUTCOME MEASURES

Loss of weight during treatment, complication rate, PEG duration.

RESULTS

The mean loss of weight during treatment for all patients was only 2.8%. One complication of tube placement occurred: a colon perforation, treated successfully by surgery. The median duration of the PEG was 178 days. Three of the 17 patients (18%) with no evidence of disease (NED) still had a PEG at their last follow-up visit. Of the 26 patients who died of their cancer, 13 used the PEG until death.

CONCLUSIONS

Loss of weight was limited after prophylactic gastrostomy placement and early tube feeding. Moreover, the complication rate was low. In 82% of the NED patients the PEG could eventually be removed.

Authors+Show Affiliations

Department of Radiotherapy, Leiden University Medical Center (LUMC), Leiden, The Netherlands. r.wiggernraad@mchaaglanden.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17883560

Citation

Wiggenraad, R G J., et al. "Prophylactic Gastrostomy Placement and Early Tube Feeding May Limit Loss of Weight During Chemoradiotherapy for Advanced Head and Neck Cancer, a Preliminary Study." Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, vol. 32, no. 5, 2007, pp. 384-90.
Wiggenraad RG, Flierman L, Goossens A, et al. Prophylactic gastrostomy placement and early tube feeding may limit loss of weight during chemoradiotherapy for advanced head and neck cancer, a preliminary study. Clin Otolaryngol. 2007;32(5):384-90.
Wiggenraad, R. G., Flierman, L., Goossens, A., Brand, R., Verschuur, H. P., Croll, G. A., Moser, L. E., & Vriesendorp, R. (2007). Prophylactic gastrostomy placement and early tube feeding may limit loss of weight during chemoradiotherapy for advanced head and neck cancer, a preliminary study. Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 32(5), 384-90.
Wiggenraad RG, et al. Prophylactic Gastrostomy Placement and Early Tube Feeding May Limit Loss of Weight During Chemoradiotherapy for Advanced Head and Neck Cancer, a Preliminary Study. Clin Otolaryngol. 2007;32(5):384-90. PubMed PMID: 17883560.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic gastrostomy placement and early tube feeding may limit loss of weight during chemoradiotherapy for advanced head and neck cancer, a preliminary study. AU - Wiggenraad,R G J, AU - Flierman,L, AU - Goossens,A, AU - Brand,R, AU - Verschuur,H P, AU - Croll,G A, AU - Moser,L E C, AU - Vriesendorp,R, PY - 2007/9/22/pubmed PY - 2008/1/4/medline PY - 2007/9/22/entrez SP - 384 EP - 90 JF - Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery JO - Clin Otolaryngol VL - 32 IS - 5 N2 - OBJECTIVES: Most patients with advanced head and neck cancer receiving chemoradiotherapy need tube feeding for at least some weeks. For these periods gastrostomy tubes have advantages over nasogastric tubes. Tube feeding may start earlier and thus loss of weight may be limited if the gastrostomy tube already is in place. The objective of this study is to analyse the results of prophylactic percutaneous endoscopic gastrostomy (PEG) tube placement and early tube feeding. DESIGN: Retrospective chart review. SETTING: Multidisciplinary head and neck oncology team in a general hospital. PARTICIPANTS: Fifty consecutive patients with unresectable stage III and IV head and neck cancer treated with concurrent chemoradiotherapy. In all patients prophylactic PEG placement was performed. Tube feeding was initiated if food-intake became insufficient or loss of weight occurred. MAIN OUTCOME MEASURES: Loss of weight during treatment, complication rate, PEG duration. RESULTS: The mean loss of weight during treatment for all patients was only 2.8%. One complication of tube placement occurred: a colon perforation, treated successfully by surgery. The median duration of the PEG was 178 days. Three of the 17 patients (18%) with no evidence of disease (NED) still had a PEG at their last follow-up visit. Of the 26 patients who died of their cancer, 13 used the PEG until death. CONCLUSIONS: Loss of weight was limited after prophylactic gastrostomy placement and early tube feeding. Moreover, the complication rate was low. In 82% of the NED patients the PEG could eventually be removed. SN - 1749-4478 UR - https://www.unboundmedicine.com/medline/citation/17883560/Prophylactic_gastrostomy_placement_and_early_tube_feeding_may_limit_loss_of_weight_during_chemoradiotherapy_for_advanced_head_and_neck_cancer_a_preliminary_study_ L2 - https://doi.org/10.1111/j.1749-4486.2007.01533.x DB - PRIME DP - Unbound Medicine ER -