IMPACT OF EARLY PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE PLACEMENT ON NUTRITIONAL STATUS AND HOSPITALIZATION IN PATIENTS WITH HEAD AND NECK CANCER RECEIVING DEFINITIVE CHEMORADIATION THERAPY

Background. This study analyzed the impact of timing of percutaneous endoscopic gastrostomy (PEG) tube placement on clinical endpoints in patients undergoing concurrent chemoradiation therapy (CRT). Methods. In all, 111 patients who underwent CRT for locally advanced squamous cell carcinoma of the head and neck (SCCHN) were retrospectively analyzed to determine the effect of timing of PEG placement on weight loss, hospitalizations, and rates of PEG complications/dependence. Results. Early PEG tube placement was correlated to reductions in weight loss during CRT (p < .001, R = 0.495), hospitalization for nutritional deficits (p = .011, R = 0.262), and magnitude of persistent weight loss at 6 weeks post-CRT (p = .003, R = 0.347). Disease control was the only predictor of PEG dependence. No differences were seen in PEG complication or dependence rates with earlier placement. Conclusions. The results of our series show that patients with locally advanced SCCHN undergoing definitive CRT may derive significant clinical benefit from the early placement of PEG tubes for nutritional supplementation. (C) 2010 Wiley Periodicals, Inc. Head Neck 33: 1441-1447, 2011