Treatment Interruption and Hospital Admission in Head and Neck Cancer Patients during Concurrent Chemoradiotherapy with or without Prophylactic Nasogastric Tube Feeding

Abstract

Background: Worldwide, head and neck cancer (HNC) was the 6th most common cancer in 2020 in all ages and both sexes. In Bangladesh, lip and oral cavity cancer was the 2nd most common cancer in 2020. Up to 60% of HNC patients presents with locally advanced disease. Aim and Objective: To determine treatment Interruption and hospital admission in head and neck cancer patients during concurrent chemoradiotherapy with or without prophylactic nasogastric tube feeding. Materials and Method: A quasi-experimental study was performed in Radiation Oncology Department of National Institute of Cancer Research & Hospital from 1st January 2020 to 31st December 2020. A total number of 68 Patients (34 patients in each arm) was included in this study according to inclusion and exclusion criteria by purposive Sampling technique. All patients in Arm A and Arm B were planned for total 66 Gray in 33 daily fractions, 2 Gray per fraction, 1 fraction per day, 5 fractions per week over 6½ weeks and inj. Cisplatin 40mg/m² was given intravenously 2 hours before radiotherapy on 1st day and then weekly. All the information’s were recorded in a pre-tested and semi-structured questionnaire. The analysis was done by using independent sample t test for continuous variables and chi-square test for categorical variables and data were presented in tables and graphs. Results: In this study, mean age was 52.5 ± 8.5 years and male: female ratio was 4.2: 1 among all patients. The Incidence of treatment interruption was significantly lower in Arm A compared with Arm B (29.4% in Arm A and 70.6% in Arm B, p-value < 0.05). There were fewer patients who required hospitalization in Arm A (23.5% in Arm A and 55.9% in Arm B) and length of hospital stay was less too (5.3 ± 1.7 in Arm A and 10.0 ± 1.9 in Arm B, p value <0.05). There were no significant differences in treatment response and toxicities between the two groups. Conclusion: Prophylactic nasogastric tube feeding at the beginning of CCRT in head and cancer patients is beneficial in terms of preventing treatment break and reducing hospital admission.