Percutaneous endoscopic gastrostomy tube dependence following chemoradiation in head and neck cancer patients

Laryngoscope. 2015 Jun;125(6):1366-71. doi: 10.1002/lary.25117. Epub 2015 Feb 3.


Objectives/hypothesis: Compare long-term percutaneous endoscopic gastrostomy (PEG) tube dependence, stricture rate, and weight loss in patients receiving a prophylactic gastrostomy tube with those who initially rely on oral intake during chemoradiation for head and neck cancer. Also, to determine what other patient and treatment characteristics influence development of long-term severe dysphagia.

Study design: Retrospective review.

Methods: Seventy-nine patients received a PEG tube and 25 did not. The prophylactic and initial oral intake groups were then analyzed to assess the primary outcomes of PEG dependence at last follow-up >1 year.

Results: On univariate and multivariate analysis, Zubrod score >1, prophylactic PEG placement, and higher T classification were predicted for PEG tube dependence at last follow-up at least 1 year after treatment.

Conclusions: Prophylactic PEG tube, high Zubrod score, and high T stage were independent predictors for PEG tube dependence at least 1 year after treatment in patients with head and neck cancer receiving definitive chemoradiation.

Level of evidence: 4.

Keywords: Radiation therapy; dysphagia; swallowing.

MeSH terms

  • Chemoradiotherapy*
  • Deglutition
  • Female
  • Gastroscopy*
  • Gastrostomy / instrumentation
  • Gastrostomy / methods*
  • Head and Neck Neoplasms / physiopathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Intubation, Gastrointestinal / instrumentation
  • Male
  • Middle Aged
  • Retrospective Studies