Swallowing outcomes and PEG dependence in head and neck cancer patients receiving definitive or adjuvant radiotherapy +/− chemotherapy with a proactive PEG: A prospective study with long term follow up

•Proactive PEG did not lead to high proportion of long term tube dependence.•Majority of patients with proactive PEG had good swallowing outcomes.•Post PEG removal, nearly all patients tolerated thin fluids and over half tolerated a normal diet.

SummaryObjectivesThis study examined long term swallowing outcomes of a cohort of head and neck cancer (HNC) patients identified at high risk of experiencing significant side effects from cancer treatment and were provided with a proactive PEG.Material and MethodsNinety-five HNC patients receiving definitive or adjuvant radiotherapy +/− chemotherapy were identified for proactive PEG placement using validated guidelines and followed for up to 3 years. Functional swallowing status was recorded at regular time points and data were collected on PEG use and duration in situ.ResultsMean duration of enteral feeding was 125 days. PEGs remained in situ for approximately 7 months. PEG removal was achieved by 52% by 6 months and 86% by 1 year. Only 3 (3%) remained PEG dependent at 3 years. Over half (55%) had resumed a full non-texture modified diet by PEG removal.ConclusionProactive PEG placement did not lead to high proportion of long term tube dependence in this high risk group and the majority achieved good swallowing outcomes.