Brown T, et al. – Given to the research, prophylactic gastrostomy tube (PGT) was frequently used in patients with head and neck cancer (HNSCC). Aim was to find out whether early feeding via PGT impacted on longer term tube feeding outcomes. Results reported high PGT use in the acute phase post–treatment. Although not increased long term dependency rates beyond four months post treatment, encouraging early use seemed to prolong time to tube removal. In order to prevent over–estimation of dependency rates, monitoring tube use was important.

Methods

• Regarding tube use and time to removal up to twelve months, clinicians observed patients with HNSCC with PGT monthly post-treatment.
• They selected patients from a randomised controlled trial comparing an early feeding intervention via the PGT (n=57) versus usual care which commenced feeding when clinically indicated (n=67).

Results

• Male (88%), mean age 60±10.1 years, oropharyngeal tumours (76%), receiving chemoradiotherapy (82%) were the characteristics of patient.
• Results revealed the use of tubes by 87% (108/124) on completion of treatment and 66% (83/124) one month post.
• There were no differences in tube use between groups at any time point or tube removal rates over 12 months (p=0.181).
• Data demonstrated that the intervention had higher tube use at 4 months (p=0.003) and slower removal rates (p=0.047), in patients free of disease (n=99).
• They found that ten patients had their tube in-situ at 12 months (8%).
• However, five were awaiting removal (4% true dependency rate).
• Only one (<1%) was from severe dysphagia post definitive chemoradiotherapy, among the five patients legitimately using the tube.