Toxicities and costs of placing prophylactic and reactive percutaneous gastrostomy tubes in patients with locally advanced head and neck cancers treated with chemoradiotherapy. Issue 8 (27th November 2013)

• Record Type: Journal Article
• Authors: Baschnagel, Andrew M.; Yadav, Siddhartha; Marina, Ovidiu; Parzuchowski, Aaron; Lanni, Thomas B.; Warner, Jillian N.; Parzuchowski, Jeanne S.; Ignatius, Renjitha T.; Akervall, Jan; Chen, Peter Y.; Krauss, Daniel J.
• Is Part Of: Head & neck. Volume 36:Issue 8(2014:Aug.)
• Page Start: 1155
• Page End: 1161
• Publication Date: 2013-11-27
• Subjects: Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.23426
• Languages: English
• ISSNs: 1043-3074

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="hed23426-sec-0001" sec-type="section"> <title>Background</title> <p>We compared dependence rates, complications, toxicities, and costs associated with prophylactic versus reactive percutaneous endoscopic gastrostomy (PEG) tube placement.</p> </sec> <sec id="hed23426-sec-0002" sec-type="section"> <title>Methods</title> <p>One hundred ninety‐three patients with locally advanced head and neck squamous cell carcinoma treated with concurrent chemoradiotherapy were retrospectively reviewed.</p> </sec> <sec id="hed23426-sec-0003" sec-type="section"> <title>Results</title> <p>The 1‐year and 2‐year actuarial PEG tube dependence rate of the entire cohort was 24% and 13%, respectively. There was no difference in the PEG tube dependence rates between those placed prophylactically versus reactively. Patients who received a PEG tube reactively had a significantly higher stricture rate (<italic>p</italic> = .03) and aspiration rate (<italic>p</italic> < .001) compared to the prophylactic group. There were significantly fewer hospitalizations in the prophylactic group compared to the reactive group (<italic>p</italic> = .003). When accounting for both PEG placement and hospitalizations, the prophylactic approach was found to be more cost effective.</p> </sec> <sec id="hed23426-sec-0004" sec-type="section"> <title>Conclusion</title> <p>PEG tubes placed prophylactically were associated with lower rates of strictures, aspirations, hospitalizations, and costs compared to those placed reactively. © 2013 Wiley Periodicals, Inc. <italic>Head Neck</italic> 36: 1155–1161, 2014</p> </sec> </abstract>