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

ABSTRACT Background Dysphagia is common in head and neck cancer. A percutaneous endoscopic gastrostomy (PEG) tube is used to facilitate nutrition; however, some retrospective studies have indicated that the PEG tube causes dysphagia. Methods A randomized study of patients with head and neck cancer w...

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Published in:Head & neck 2017-05, Vol.39 (5), p.908-915
Main Authors: Axelsson, Lars, Silander, Ewa, Nyman, Jan, Bove, Mogens, Johansson, Leif, Hammerlid, Eva
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Deglutition Disorders - prevention & control
dysphagia
Endoscopy
Female
Follow-Up Studies
Gastrostomy
head and neck cancer
Head and Neck Neoplasms - mortality
Head and Neck Neoplasms - pathology
Head and Neck Neoplasms - surgery
Humans
Kirurgi
Male
Malnutrition - prevention & control
Middle Aged
Nutritional Support
Oto-rino-laryngologi
Otorhinolaryngology
percutaneous endoscopic gastrostomy
Postoperative Complications - prevention & control
randomized controlled study
Surgery
Survival Rate
swallowing function
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Summary:ABSTRACT Background Dysphagia is common in head and neck cancer. A percutaneous endoscopic gastrostomy (PEG) tube is used to facilitate nutrition; however, some retrospective studies have indicated that the PEG tube causes dysphagia. Methods A randomized study of patients with head and neck cancer was conducted with up to 10 years of follow‐up. Patients were randomized to either the prophylactic PEG tube group (study group) or the common clinical nutritional support group (control group). At each follow‐up, a dietician assessed the oral intake, noted the patients' weight, and if the patients used a PEG tube. Dysphagia was also assessed by the quality of life questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐Core 30 Head and Neck 35‐questions (EORTC‐QLQ‐H&N35). Results One hundred thirty‐four patients were included in this study. There was no significant difference in swallowing function between the groups after 12 months, 24 months, and 8 years based on the EORTC‐QLQ‐H&N35, the oral intake scale, tube dependence, esophageal intervention, weight, body mass index (BMI), and overall survival. Conclusion 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
ISSN:1043-3074
1097-0347
1097-0347
DOI:10.1002/hed.24707