Prophylactic Gastrostomy Tubes in Patients Undergoing Intensive Irradiation for Cancer of the Head and Neck

Abstract

The use of PGTs significantly reduces weight loss and the rate of hospitalization for dehydration and complications of mucositis. Treatment interruptions may also be avoided by the use of PGTs in patients with good performance status. We encourage patients scheduled for intensive radiation therapy to receive a PGT.

Comparison of Treatment Compliance and Nutritional Outcomes among Patients with Nasopharyngeal Carcinoma with and without Percutaneous Endoscopic Gastrostomy during Chemoradiation

“…Concerning treatment toxicity, we found that there were no haematological and renal toxicity differences between the PPEG and non-PPEG groups, which were similar to findings of other PPEG studies in other head and neck cancers (Lee et al, 1998;Assenat et al, 2011). However the effect of PPEG on patient's potassium status was different between the groups.…”

“…Nourishment can be undertaken via percutaneous endoscopic gastrostomy and inserting the feeding tube to the stomach through the abdominal wall before radiation, called "prophylactic percutaneous endoscopic gastrostomy" (PPEG). PPEG has been effective in the maintenance of weight, reduced set-up error, reduced hospitalisation, reduced treatment interruption and improved quality of life (Lee et al, 1998;Chang et al, 2009;Mercuri et al, 2009;Salas et al, 2009;Chen et al, 2010;Assenat et al, 2011;Silander et al, 2011).…”

Defining the Indications for Prophylactic Percutaneous Endoscopic Gastrostomy Tubes in Surgically Treated Head and Neck Cancer Patients

“…Prior studies have shown that if these patients are not supplemented, they will likely experience severe dehydration, treatment intolerance, or severe treatment related complications that require hospitalization. 3, 4 Inherently, the surgical treatment of head and neck malignancies can be quite debilitating and result in significant mastication and deglutination dysfunction. [5][6][7] At times this involves radical resections that require complex reconstructions to maintain oropharyngeal continuity; and adjuvant radiation and/or chemotherapy may be required to maximize local control.…”

“…Groups have identified some factors that are predictive of a need for enteral support. 3,4,[14][15][16][17] One factor that has been clearly established is radiation therapy, particular when given postoperatively. 3,4,17 Other factors such as Stage IV disease, base of tongue tumor location, and heavy alcohol ingestion are less clearly defined.…”

“…3,4,[14][15][16][17] One factor that has been clearly established is radiation therapy, particular when given postoperatively. 3,4,17 Other factors such as Stage IV disease, base of tongue tumor location, and heavy alcohol ingestion are less clearly defined. [14][15][16] Some criticisms have been that the studies conducted to identify these variables were small, used a mixed population of surgical and non-surgical patients, and often used durations of enteral support that were short (< 4 weeks) or undefined.…”