Safety and effectiveness of prophylactic gastrostomy tubes for head and neck cancer patients undergoing chemoradiation

Nam P. Nguyen, Debra North, Herbert J. Smith, Suresh Dutta, Alan Alfieri, Ulf Karlsson, Howard Lee, Tomas Martinez, Claire Lemanski, Ly M. Nguyen, Adir Ludin, Sabah Sallah

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88 Scopus citations

Abstract

Background: We would like to assess the safety and effectiveness of prophylactic percutaneous endoscopic gastrostomy (PEG) tube feedings during concurrent chemoradiation for head and neck cancer. Methods: Patients who underwent chemotherapy and radiation for head and neck malignancies were evaluated for their ability to resume oral feeding following treatment. All patients underwent PEG tube placement prior to the treatment because of the expected mucositis. Gastrostomy tubes were removed following treatment when the patients were able to resume oral feedings without aspiration. Results: Between March 1999 and 2006, 104 patients with locally advanced head and neck cancer underwent concurrent chemotherapy and radiation. One patient declined placement of gastrostomy tube. Ninety patients (86%) developed grade 3-4 mucositis during chemoradiation. Five patients died during treatment from aspiration pneumonia and sepsis. One hundred two patients lost weight during treatment. The mean and median weight loss during concurrent therapy was, respectively, 8.5 and 8 kg (1-23.5 kg). Following treatment, tube feedings were continued 1-41 months (mean: 8 months; median: 5 months) because of continued weight loss, chronic dysphagia, or aspiration. At a median follow-up of 19 months (1-62 months), no patient developed serious complications from tube feedings. Conclusion: Dysphagia resulting from the severe mucositis produced severe weight loss, despite tube feedings. Gastrostomy tube feedings are safe. Gastrostomy tubes should be placed prophylactically for patients undergoing chemoradiation for head and neck cancer.

Original languageEnglish (US)
Pages (from-to)199-203
Number of pages5
JournalSurgical Oncology
Volume15
Issue number4
DOIs
StatePublished - Dec 1 2006

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Keywords

  • Chemoradiation
  • Dysphagia
  • Head and neck cancer
  • Tube feedings

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Nguyen, N. P., North, D., Smith, H. J., Dutta, S., Alfieri, A., Karlsson, U., Lee, H., Martinez, T., Lemanski, C., Nguyen, L. M., Ludin, A., & Sallah, S. (2006). Safety and effectiveness of prophylactic gastrostomy tubes for head and neck cancer patients undergoing chemoradiation. Surgical Oncology, 15(4), 199-203. https://doi.org/10.1016/j.suronc.2006.12.002