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

Oral Oncol. 2015 Jun;51(6):622-8. doi: 10.1016/j.oraloncology.2015.03.006. Epub 2015 Apr 10.

Abstract

Objectives: 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.

Material and 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.

Conclusion: 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.

Keywords: Cancer; Chemoradiotherapy; PEG; Proactive; Radiotherapy; Swallowing.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chemoradiotherapy
  • Deglutition / physiology*
  • Deglutition Disorders / etiology*
  • Enteral Nutrition / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms* / complications
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Male
  • Malnutrition / prevention & control*
  • Middle Aged
  • Prospective Studies
  • Radiotherapy, Adjuvant
  • Time Factors
  • Treatment Outcome