Prophylactic percutaneous endoscopic gastrostomy tube placement in treatment of head and neck cancer: a comprehensive review and call for evidence-based medicine
Department of Quantitative Health Sciences
Medical Subject Headings
Head and Neck Neoplasms; Gastrostomy; Endoscopy
Biostatistics | Epidemiology | Health Services Research | Oncology
Background: Patients with head and neck cancers (HNCs) are at increased risk of experiencing malnutrition, which is associated with poor outcomes. Advances in the treatment of HNCs have resulted in improved outcomes that are associated with severe toxic oral side effects, placing patients at an even greater risk of malnutrition. Prophylactic placement of percutaneous endoscopic gastrostomy (PEG) tubes before treatment may be beneficial in patients with HNC, especially those undergoing more intense treatment regimens. PEG tube placement, however, is not without risks.
Methods: A comprehensive review of the literature was conducted.
Results: Systematic evidence assessing both the benefits and harm associated with prophylactic PEG tube placement in patients undergoing treatment for HNC is weak, and benefits and harm have not been established.
Conclusions: More research is necessary to inform physician behavior on whether prophylactic PEG tube placement is warranted in the treatment of HNC.
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Citation: JPEN J Parenter Enteral Nutr. 2011 May-Jun;35(3):365-74. Link to article on publisher's site
Locher, Julie L.; Bonner, James A.; Carroll, William R.; Caudell, Jimmy J.; Keith, Jeanette N.; Kilgore, Meredith L.; Ritchie, Christine S.; Roth, David L.; Tajeu, Gabriel S.; and Allison, Jeroan J., "Prophylactic percutaneous endoscopic gastrostomy tube placement in treatment of head and neck cancer: a comprehensive review and call for evidence-based medicine" (2011). Quantitative Health Sciences Publications and Presentations. Paper 975.