(Press-News.org) Impairment of oral intake occurs in the majority of patients with head and neck cancer (HNC) receiving chemoradiotherapy. Placement of prophylactic percutaneous endoscopic gastrostomy (PEG) tube in asymptomatic newly diagnosed HNC before chemoradiation is a common practice in some centers. In some studies, PEG has been associated with a decrease in treatment related weight loss in patients with HNC, but no studies have examined the utilization rate.
A research article published on February 28, 2011 in the World Journal of Gastroenterology addresses this question. The authors have observed anecdotally that a number of HNC patients who received a prophylactic PEG tube in fact never used them. They performed a retrospective database study of all patients in whom PEG tube was placed for HNC to determine the prevalence of unused prophylactically placed PEG tubes. Data were also analyzed for possible factors predictive of unused PEGs or PEGs used for less than 2 wk.
This is the first study that addressed the issue of use of prophylactic PEG in HNC patients. The result of this study showed that a significant number of patients (47%) with prophylactic PEG tubes never used their PEG or used it for less than 2 wk. No association with PEG use vs non-use was observed for cancer diagnosis, stage, or specific cancer treatment.
The study suggests prophylactic PEG placement prior to HNC therapy is associated with a high rate of non use or limited use. Further prospective studies evaluating specific selection criteria for prophylactic PEG in this setting are needed. Similarly, additional studies are needed to assess the impact of prophylactic PEG tube placement on the cost-effectiveness of cancer care, quality of life, hospital admission rate, and, most importantly, survival.
INFORMATION:
Reference: Madhoun MF, Blankenship MM, Blankenship DM, Krempl GA, Tierney WM. Prophylactic PEG placement in head and neck cancer: How many feeding tubes are unused (and unnecessary)? World J Gastroenterol 2011; 17(8): 1004-1008
http://www.wjgnet.com/1007-9327/full/v17/i8/1004.htm
Correspondence to: Mohammad F Madhoun, MD, Section of Gastroenterology, Department of Internal Medicine, University of Oklahoma Health Sciences Center, 920 SL. Young Blvd; WP1360, Oklahoma City, OK 73104, United States. mohammad-madhoun@ouhsc.edu
Telephone: +1-405-2715428 Fax: +1-405-2717186
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2009 IF: 2.092. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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