Effect of prophylactic percutaneous endoscopic gastrostomy tube on swallowing in advanced head and neck cancer: A randomized controlled study

Axelsson, Lars; Silander, Ewa; Nyman, Jan; Bove, Mogens; Johansson, Leif; Hammerlid, Eva

doi:10.1002/hed.24707

Cited by 45 publications

(56 citation statements)

References 24 publications

(68 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…15 Study has shown that early percutaneous endoscopic gastrostomy (PEG) placement can increase the completeness rate of concurrent chemotherapy. 42 Although PEG catheterization is more receptive than nasogastric tubes, studies [43][44][45] have also shown that PEG may result in a decrease in swallowing process. [33][34][35][36][37] Studies have shown that prophylactic PEG can improve quality of life 38 and reduce the risk of aspiration, hospitalization, medical costs, 39 weight loss, length of stay, 40 and radiotherapy interruption rate.…”

Section: Discussionmentioning

confidence: 99%

“…41 Prophylactic PEG was more common than reactive PEG in abroad, with rate of catheterization 51.75% and 13.5%, respectively. 42 Although PEG catheterization is more receptive than nasogastric tubes, studies [43][44][45] have also shown that PEG may result in a decrease in swallowing process. It was suggested that PEG may not be considered before the radiation dose reaches 30 Gy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Home enteral nutrition may prevent myelosuppression of patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy

Zhou

Chu

et al. 2019

Head & Neck

View full text Add to dashboard Cite

Background The aim of this study is to assess the effect of home enteral nutrition (HEN) on the myelosuppression of patients with nasopharyngeal cancer (NPC) during the course of concurrent chemoradiotherapy (CCRT). Methods A total of 18 outpatients with NPC administered oral nutritional supplementation intervention at home during the course of CCRT were designated as the HEN group, whereas 36 patients with NPC who had previously completed CCRT were retrospectively included as the control group. Patient Generated Subjective Global Assessment, body mass index (BMI), and blood test were evaluated prior to CCRT. During the course of CCRT, blood test was assessed every 2 weeks. Results In male patients, hemoglobin (HB) and red blood cell were decreased (P < .05) in both HEN and control group after CCRT, whereas white blood cell (WBC) started to decrease since week 2 of CCRT in the control group but maintained in the HEN group which was significantly higher than the control (5.05 ± 1.29 vs 3.77 ± 1.5, P < .05). In female patients, HB and WBC were reduced in control group during CCRT, whereas these indicators also maintained in the HEN group. Surprisingly, all patients with lower BMI (<24 kg/m2) had a significant increase in platelet (PLT) after CCRT (200.78 ± 58.03 vs 253.00 ± 69.82, P < .05), while had steady HB and WBC values in the HEN group. At the end of CCRT, WBC and PLT of the HEN group were both higher than those in the control group (5.21 ± 1.07 vs 3.37 ± 1.52), (253.00 ± 69.82 vs 165.57 ± 59.56) (P < .05 for both). Our findings suggest that HEN is effective in preventing myelosuppression during CCRT for patients with NPC. Conclusion Our findings suggest that HEN is effective in preventing myelosuppression during CCRT for patients with NPC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Home enteral nutrition may prevent myelosuppression of patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy

Zhou

Chu

et al. 2019

Head & Neck

View full text Add to dashboard Cite

show abstract

“…There is an ongoing question in our field as to whether prophylactic feeding tube placement may contribute to long‐term dysphagia. Past studies have had mixed results, with some showing better long‐term quality of life and shorter tube dependence without prophylactic gastrostomy tube placement and others refuting this . Unfortunately, we are unable to determine definitively from our data which gastrostomy tubes were placed prophylactically and which were placed reactively, therefore, we were unable to analyze the possible contribution of this risk factor.…”

Section: Discussionmentioning

confidence: 75%

Individualized prediction of late‐onset dysphagia in head and neck cancer survivors

et al. 2020

View full text Add to dashboard Cite

Background Limited data exist regarding which head and head and neck cancer (HNC) survivors will suffer from long‐term dysphagia. Methods From a population‐based cohort of 1901 Utah residents with HNC and ≥3 years follow‐up, we determined hazard ratio for dysphagia, aspiration pneumonia, or gastrostomy associated with various risk factors. We tested prediction models with combinations of factors and then assessed discrimination of our final model. Results Cancer site in the hypopharynx, advanced tumor classification, chemoradiation, preexisting dysphagia, stroke, dementia, esophagitis, esophageal spasm, esophageal stricture, gastroesophageal reflux, thrush, or chronic obstructive pulmonary disease were associated with increased risk of long‐term dysphagia. Our final prediction tool gives personalized risk calculation for diagnosis of dysphagia, aspiration pneumonia, or gastrostomy tube placement at 5, 10, and 15 years after HNC based on 18 factors. Conclusion We developed a clinically useful risk prediction tool to identify HNC survivors most at risk for dysphagia.

show abstract

“…However, these were either small in sample size or evaluated heterogenous patient cohorts . One of the major concerns is the potential risk of prolonged tube dependency and swallow musculature atrophy, however a recent prospective study from Sweden was able to show that patients with PEG tube do not have an increased risk in a long‐term follow up …”

Section: Discussionmentioning

confidence: 99%

Prophylactic percutaneous endoscopic gastrostomy in patients with head and neck cancer: Influence on nutritional status, utilisation rate and complications

et al. 2019

View full text Add to dashboard Cite

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractBackground: Patients with head and neck cancer (HNC) are at high risk for malnutrition because of tumour localisation and therapy. Prophylactic percutaneous endoscopic gastrostomy (PEG) tube placement is common practice to prevent malnutrition.Objective: To investigate the benefits of prophylactic PEG tube placement for HNC patients in terms of the influence on patients' nutritional status, utilisation rate, complications and to identify the predictors of PEG tube utilisation. Methods:All consecutive HNC patients who underwent prophylactic PEG tube insertion between 1 January 2011 and 31 December 2012 prior to therapy were enrolled. The PEG tube utilisation rate, complications, the patients' nutritional status and tumour therapy were evaluated with the help of electronic patient charts and telephone interviews.Results: A total of 181 patients (48 female, median 67.5 years) were included. The PEG utilisation rate in the entire cohort was 91.7%. One hundred and forty-nine patients (82.3%) used the PEG tube for total enteral nutrition, 17 patients (9.4%) for supplemental nutrition and 15 patients (8.3%) made no use of the PEG tube. Peristomal wound infections were the most common complications (40.3%) in this study. A high Nutritional Risk Screening (NRS) score prior to tube insertion was found to be independently associated with PEG utilisation. No significant weight changes were observed across the three patient subgroups. Conclusions:The overall PEG tube utilisation rate was high in this study. However, given the high rate of infections, diligent patient selection is crucial in order to determine which patients benefit most from prophylactic PEG tube insertion. Entire cohort N = 161 Amount of total positive findings, N (%) 70 (43.48) Diagnosis during EGD Gastritis, N(%) 24 (34.29) Gastric erythema, N (%) 19 (27.14) Reflux oesophagitis, N (%) 4 (5.71) Gastric ulcus, N (%) 6 (8.57) Duodenal ulcus, N (%) 3 (4.29) Malignant duodenal tumour, N (%) 1 (1.43) Hiatal hernia, N (%) 6 (8.57) Erosive oesophagitis, N (%) 4 (5.71) Glycogen acanthosis N (%) 3 (4.29)

show abstract

Effect of prophylactic percutaneous endoscopic gastrostomy tube on swallowing in advanced head and neck cancer: A randomized controlled study

Abstract: 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.

Cited by 45 publications

References 24 publications

Home enteral nutrition may prevent myelosuppression of patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy

Home enteral nutrition may prevent myelosuppression of patients with nasopharyngeal carcinoma treated by concurrent chemoradiotherapy

Individualized prediction of late‐onset dysphagia in head and neck cancer survivors

Prophylactic percutaneous endoscopic gastrostomy in patients with head and neck cancer: Influence on nutritional status, utilisation rate and complications

Contact Info

Product

Resources

About