Percutaneous endoscopic gastrostomy does not affect quality of life in HNC patients

Prophylactic insertion of percutaneous endoscopic gastrostomy (PEG) tubes does not improve quality of life in patients with head and neck cancer (HNC), a recent study has shown.

Researchers enrolled 181 HNC patients (median age, 64 years; 73.5 percent male) who had had PEG tubes inserted before receiving cancer treatment. The European Organization for Research and Treatment of Cancer Quality of life questionnaire (EORTC-QLQ) was used to quantify the study outcome.

Participants were categorized into three groups according to the use of the feeding tubes: total nutrition (group A; n=149), supplemental nutrition to complement oral food intake (group B; n=17) or no use of the feeding tube (group C; n=15).

At a median of 21.6 months after PEG insertion, 50.3 percent (n=91) of the patients agreed to be interviewed over the phone. Median overall QLQ scores at follow-up for groups A, B and C were 50.0, 41.6 and 58.3, respectively. Statistical significance was not achieved (p=0.378).

However, analysis by individual scales revealed important differences. Bodily function, for example, appeared to be better in patients who used PEG tubes less (median scores: group A, 66.6; group B, 80.0; group C, 93.3; p=0.034). No such differences were found for social, cognitive and emotional function.

Similarly, symptom burden of fatigue (p=0.869), pain (p=0.375) and nausea/emesis (p=0.667) were all unaffected by the use of PEG tubes.

There were significant differences in the subjective evaluations of PEG tubes. Those in groups A and B, for example, generally perceived PEG tubes to be beneficial and were more open to undergoing a repeat procedure in the future.