Prophylactic percutaneous endoscopic gastrostomy tube feeding to prevent weight loss in head and neck cancer patients- a retrospective cohort study

Abstract

Author(s): Ciniraj Raveendran, I Yadev, Krishna Sharan, Bejadi Vadhiraja

Significant weight loss occurs in head and neck cancer patients who receive concurrent chemo radiation. Prophylactic use of Percutaneous Endoscopic Gastrostomy (PEG) tube has not been well explored. This study aimed to compare the weight loss in head and neck cancer patients treated with concurrent chemo radiotherapy with or without a PEG tube Methods: This was a retrospective cohort study that included patients with head and neck cancers treated with concurrent chemo radiation with or without PEG feeding. All patients, irrespective of their feeding status, were on a regular diet. Bodyweight during treatment was compared between patients without PEG feeding and PEG feeding. Chi-square test and Mann Whitney U test were used to compare the groups. Mixed method analysis of variance (ANOVA) was used to model the difference in the outcome variables across different time points. Results: A total of 80 patients were studied, of whom 29 received PEG feeding prophylactically, and 51 did not. The median weight of all patients had a decreasing trend from the beginning until the completion of treatment. The difference between the two groups reached statistical significance by week four and maintained the significant difference at week five and week six, P=.04, P=.39, P=.05, respectively. Pairwise comparison of weight across the two groups without taking into consideration the effects of time showed a statistically significant difference (P<.001). However, there was no statistically significant difference between the two groups when the observations were modelled with mixed-method ANOVA (F=3.7 and P= .052). Conclusions: Weight loss occurs in head and neck cancer patients during concurrent chemo radiation even after prophylactic PEG feeding. There was no evidence to state that nutritional intervention with PEG will result in reduced weight loss.

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