PP132: The role of early percutaneus endoscopic gastrostomy placement in patients with head and neck cancer treated by combined radiotherapy–chemotherapy

Abstract

Purpose This study evaluates the outcome of early percutaneous endoscopic gastrostomy (PEG) placement in patients treated with concurrent chemoradiotherapy for advanced head neck cancer. Materials and methods From January 2010 until May 2012 a series of consecutive patients with advanced squamous cell head and neck cancer planned for radical treatment with long course or hypofractionated radiation therapy, underwent PEG placement. We retrospectively analyzed their records to determine the effect of early PEG placement on treatment completion without interruption. It is well known that combined chemoradiotherapy increases mucosal toxicity leading to decreased nutritional intake, weight loss and treatment interruption. Patients had a planning CT scan using individual immobilization with a thermoplastic device and were treated with 3D conformal radiotherapy to a total dose of 36 Gy in thirteen fractions ( hypofractionation schedule) or 66 Gy in 33 fractions (long course).They received concomitantly weekly platinum-based chemotherapy. Results Early percutaneous endoscopic gastrostomy (PEG) was correlated with fewer interruptions of treatment and a better nutritional status. Conclusions The results showed that patients with locally advanced head and neck carcinoma undergoing radiotherapy with curative intent and concomitant chemotherapy, had significant clinical benefit from the early placement of PEG. Prophylactic PEG maintains a sufficient nutritional status and reduces the incidence of treatment interruption due to therapy toxicity.