Predictive Factors for Prophylactic Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement and Use in Head and Neck Patients Following Intensity-Modulated Radiation Therapy (IMRT) Treatment: Concordance, Discrepancies, and the Role of Gabapentin

Dysphagia ◽  
2016 ◽  
Vol 31 (2) ◽  
pp. 206-213 ◽  
Author(s):  
Wuyang Yang ◽  
Todd R. McNutt ◽  
Sara A. Dudley ◽  
Rachit Kumar ◽  
Heather M. Starmer ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Predictive Factors ◽  
Intensity Modulated Radiation Therapy ◽  
Tube Placement ◽  
Intensity Modulated ◽  
Endoscopic Gastrostomy ◽  
Peg Tube

scholarly journals Unplanned hospitalizations in patients with locoregionally advanced head and neck cancer treated with (chemo)radiotherapy with and without prophylactic percutaneous endoscopic gastrostomy

2020 ◽  
Author(s):  
Beat Bojaxhiu ◽  
Binaya K. Shrestha ◽  
Pascal Luterbacher ◽  
Olgun Elicin ◽  
Mohamed Shelan ◽  
...  
Keyword(s):  
Head And Neck ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Performance Status ◽  
Poor Performance ◽  
Tube Placement ◽  
Poor Performance Status ◽  
Advanced Head ◽  
Endoscopic Gastrostomy ◽  
Increased Risk ◽  
Peg Tube

Abstract Background: Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Unreported was if omitting a pPEG is associated with an increased risk of complications leading to a treatment-related unplanned hospitalization (TRUH).Methods: TRUHs were retrospectively analyzed in patients with advanced head and neck squamous cell carcinoma (n=310) undergoing (chemo)radiotherapy with (pPEG) or without PEG (nPEG).Results: In 88 patients (28%), TRUH was reported. One of the leading causes of TRUH in nPEG patients was inadequate oral intake (n = 16, 13%), and in pPEG patients, complications after PEG tube insertion (n=12, 10%). Risk factors for TRUH were poor performance status, tobacco use, and surgical procedures.Conclusions: Omitting pPEG tube placement may be feasible in compliant patients in good general condition. Patients aged >60 years with hypopharyngeal carcinoma, tobacco consumption, and poor performance status appear at risk of PEG tube-related complications leading to an unplanned hospitalization.

scholarly journals Metastatic Implantation of Head and Neck Squamous Cell Cancer at PEG Tube Site Exit— An Unusual Relapse Site: A Case Report and Review of Literature

2011 ◽  
Vol 2 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Vijay Palwe ◽  
Kaustav Talpatra ◽  
Umesh Mahantshetty ◽  
Seethalaxmi Viswanathan
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Gastrostomy Tube Placement ◽  
Peg Tube

ABSTRACT Background The placement of percutaneous endoscopic gastrostomy (PEG) tubes is a common procedure in patients with head and neck cancer who require adequate nutrition because of the inability to swallow before or after surgery and adjuvant therapies. A potential complication of percutaneous endoscopic gastrostomy tubes is the metastatic spread from the original head and neck tumor to the gastrostomy site. Methods This is a case of a 55-year-old male with a (cT4N3M0) stage IV squamous cell carcinoma of the oropharynx who underwent percutaneous endoscopic gastrostomy tube placement prior to commencement of definitive chemoradiation therapy and 7 months thereafter developed metastatic spread to the gastrostomy site. Tumor was treated with radiation therapy. A review of the published literature regarding the subject is done. The pull-through method of gastrostomy tube placement had been used in our patient as well as in the majority of the other cases reviewed in the literature. Conclusions There is a small but definite risk for tumor implantation in the gastrostomy site when using the pull technique in patients with active head and neck cancer. The direct implantation of tumor through instrumentation is the most likely explanation for metastasis; however, hematogenous seeding is also a possibility. Careful assessment of the oropharynx and hypopharynx before PEG tube placement and the use of alternative techniques for enteral access in patients with untreated or residual malignancy are recommended to minimize this risk.

scholarly journals Unplanned hospitalizations in patients with locoregionally advanced head and neck cancer treated with (chemo)radiotherapy with and without prophylactic percutaneous endoscopic gastrostomy

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Beat Bojaxhiu ◽  
Binaya K. Shrestha ◽  
Pascal Luterbacher ◽  
Olgun Elicin ◽  
Mohamed Shelan ◽  
...  
Keyword(s):  
Head And Neck ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Performance Status ◽  
Poor Performance ◽  
Tube Placement ◽  
Poor Performance Status ◽  
Advanced Head ◽  
Endoscopic Gastrostomy ◽  
Increased Risk ◽  
Peg Tube

Abstract Background Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Unreported was if omitting a pPEG is associated with an increased risk of complications leading to a treatment-related unplanned hospitalization (TRUH). Methods TRUHs were retrospectively analyzed in patients with advanced head and neck squamous cell carcinoma (n = 310) undergoing (chemo)radiotherapy with (pPEG) or without PEG (nPEG). Results In 88 patients (28%), TRUH was reported. One of the leading causes of TRUH in nPEG patients was inadequate oral intake (n = 16, 13%), and in pPEG patients, complications after PEG tube insertion (n = 12, 10%). Risk factors for TRUH were poor performance status, tobacco use, and surgical procedures. Conclusions Omitting pPEG tube placement without increasing the risk of an unplanned hospitalization due to dysphagia, dehydration or malnutrition, is an option in patients being carefully monitored. Patients aged > 60 years with hypopharyngeal carcinoma, tobacco consumption, and poor performance status appear at risk of PEG tube-related complications leading to an unplanned hospitalization.

scholarly journals Unplanned hospitalizations in patients with locoregionally advanced head and neck cancer treated with (chemo)radiotherapy with and without prophylactic percutaneous endoscopic gastrostomy

2020 ◽  
Author(s):  
Beat Bojaxhiu ◽  
Binaya K. Shrestha ◽  
Pascal Luterbacher ◽  
Olgun Elicin ◽  
Mohamed Shelan ◽  
...  
Keyword(s):  
Head And Neck ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Performance Status ◽  
Poor Performance ◽  
Tube Placement ◽  
Poor Performance Status ◽  
Advanced Head ◽  
Endoscopic Gastrostomy ◽  
Increased Risk ◽  
Peg Tube

Abstract Background: Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Unreported was if omitting a pPEG is associated with an increased risk of complications leading to a treatment-related unplanned hospitalization (TRUH). Methods: TRUHs were retrospectively analyzed in patients with advanced head and neck squamous cell carcinoma (n=310) undergoing (chemo)radiotherapy with (pPEG) or without PEG (nPEG). Results: In 88 patients (28%), TRUH was reported. One of the leading causes of TRUH in nPEG patients was inadequate oral intake (n = 16, 13%), and in pPEG patients, complications after PEG tube insertion (n=12, 10%). Risk factors for TRUH were poor performance status, tobacco use, and surgical procedures. Conclusions: Omitting pPEG tube placement without increasing the risk of an unplanned hospitalization (UH) due to dysphagia, dehydration or malnutrition, is an option in patients being carefully monitored . Patients aged >60 years with hypopharyngeal carcinoma, tobacco consumption, and poor performance status appear at risk of PEG tube-related complications leading to an unplanned hospitalization.

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