|Comparison of key studies which commence enteral feeding via a prophylactic gastrostomy immediately|
|Citation||Study population (N)||Study design||Nutrition characteristics at baseline||Timing of PEG tube placement||Commencement of PEG feeds||Oral intake||Outcomes|
|Marcy et al. Supportive Care in Cancer 2000, 8(5):410-413||Stage IV HNC treated with chemoradiotherapy and prophylactic PEG (n = 50)||Retrospective case series||34% had BMI <20 kg/m2||Within 5 days before treatment (n = 38) or within 5 days after treatment started (n = 12)||All patients started 48 hours post insertion||Unknown||Mean weight increase of 2.5 kg by 3 weeks|
|Tube feeds were increased over 4 days to provide goal of 2000 kcal/day|
|Beer et al. Nutrition and cancer 2005, 52(1):29-34||HNC with radical radiotherapy or radiochemotherapy and PEG tube feeding (n = 151)||Retrospective comparative cohort||Group A – 49% malnourished||Group A (n = 78, 52%) early PEG: before or within 2 wk of radiotherapy.||All patients started 12 hours post insertion||Clear fluids only||Mean weight loss was 1.03 kg in group A vs. 4.0 kg in group B, (P = 0.004)|
|Group B – 47% malnourished||Group B (n = 73, 48%) delayed PEG: after 2 wk of radiotherapy.||Tube feeds were increased over 3 days to provide individual goal||Clear fluids only||Treatment interruptions of >3 days was 10% in Group A vs. 25% in Group B (P = 0.02)|
|Wiggenraad et al., Clinical otolaryngology 2007, 32(5):384-390||Stage III and IV HNC treated with chemoradiotherapy and prophylactic PEG (n = 50)||Retrospective case series||48% on puree or liquid diet||Mostly 1–2 weeks before treatment commenced (n = 3 had placed >3 weeks prior)||26% commenced prior to treatment (tube feeding initiated if reduced food-intake or weight loss)||Unknown||Mean loss of weight during treatment 2.8%|
|78% had weight loss|
KEY: HNC = Head and Neck Cancer; PEG = percutaneous endoscopic gastrostomy; BMI = body mass index.
Brown et al.
Brown et al. BMC Nursing 2014 13:17 doi:10.1186/1472-6955-13-17