Table 3

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

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