PEG status and outcomes in head and neck cancer patients treated with chemoradiotherapy.

Abstract

e17030 Background: Patients undergoing concomitant chemoradiotherapy may or may not undergo prophylactic PEG placement, depending on baseline weight, medical status and presence of dysphagia. We examined quality of life, performance status and oral outcomes in patients with or without PEG at baseline and 3 months post-treatment. Methods: Thirty-three patients with head and neck cancer were treated with chemoradiotherapy. All were seen baseline and 3 months post-tx. Assessments included the Performance Status Scale (PSS), Karnofsky Performance Status Scale (KPSS), tongue strength, jaw opening, and saliva weight. Patient-rated QOL utilized the MD Anderson Dysphagia Inventory (MDADI) and Eating Assessment Tool (EAT-10) with significance at p<.05. Results: Weight loss from baseline to 3 months post-tx was 15.16 % (p=0.000) and 10.41% (p=0.046) for those without and with PEGs, respectively. At 3 months post-tx, the PEG group performed significantly worse than the no-PEG group on the EAT-10;(p=0.050), worse on the MDADI (p=0.089) and saliva weight (p=0.032). In the no-PEG group, significant decreases from baseline to 3 months post-tx were seen for KPSS (p=0.014), Normalcy of Diet (p=0.001), Eating in Public (p=0.004),tongue strength (p=0.002), jaw opening (p=0.000), saliva weight (p=0.000), EAT-10 (p=0.001) and MDADI (p=0.016). For the PEG group, statistically significant decreases were noticed from baseline to 3 months post-tx in Normalcy of Diet (p=0.027), tongue strength (p=0.034), jaw opening (p=0.027), and saliva weight (p=0.018). Conclusion: Concomitant chemoradiotherapy for treatment of head and neck tumors can result in impaired performance outcomes and QOL over the first 3 months post-tx. However, performance status, tongue strength, jaw ROM and eating QOL were only mildly impaired by 3 months post-tx. Differences were observed in weight loss, performance status, oral outcome variables and QOL for PEG vs. no-PEG groups. However, the magnitude of the differences was not significant with the exception of the EAT-10 & saliva weight, with greater impairment in eating QOL and lower saliva weight in the PEG group.