Prophylactic versus Reactive PEG Tube Placement in Head and Neck Cancer

ObjectiveTo understand the impact of percutaneous endoscopic gastrostomy (PEG) tube placement timing on tube duration, weight loss, and disease control in patients with head and neck cancer (HNC). SettingA tertiary academic center. Study DesignHistorical cohort study. Subjects and MethodsSeventy-four patients with HNC were reviewed. Patients underwent cisplatinum-based chemoradiation therapy with or without surgical resection. They received a PEG tube either before radiation therapy began (prophylactic) or after (reactive). Patients were matched on the basis of age, gender, TNM stage, tumor subsite, human papillomavirus (HPV) status, and chemoradiation dose. ResultsPatients receiving reactive PEG tubes had them in place for fewer days than those placed prophylactically (227 vs 139 days, P <. 01). There was no difference in percentage weight loss at 2, 6, or 12 months. There was no difference in survival or disease control between the groups. ConclusionsReactive PEG tube placement may afford patients a shorter duration of usage without incurring greater weight loss or poorer oncologic outcomes.