Table 3 Comparison of key studies which commence enteral feeding via a prophylactic gastrostomy immediately

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