Tu1748 Impact of Prophylaxis Percutaneous Endoscopic Gastrostomy on Survival RATES and Nutritional Status in Patients With Nasopharyngeal Carcinoma Stage II-IV Undergoing Definitive Chemo-Radiation Therapy

Abstract

Tu1748 Impact of Prophylaxis Percutaneous Endoscopic Gastrostomy on Survival RATES and Nutritional Status in Patients With Nasopharyngeal Carcinoma Stage II-IV Undergoing Definitive Chemo-Radiation Therapy Tanawat Pattarapuntakul*, Naichaya Chamroonkul, Pimsiri Sripongpun, Bancha Ovartlarnporn Internal Medicine, Prince of Songkla University, Hatyai, Thailand; Songklanagarind Hospital, NKC institute of Gastroenterology and Hepatology, Hatyai, Thailand Background: Prophylaxis percutaneous endoscopic gastrostomy (PPEG) is routinely used as a route for nutritional support in head and neck cancer patients undergoing chemo-radiation therapy (CCRT). The nasopharyngeal cancer (NPC) has less effect to alimentary tract than other head and neck cancers and the numbers of NPC patients included were rather small in previous studies. The benefits of PPEG on patients’ survival and nutritional status in NPC patients undergoing CCRT are still unknown. Aims: To assess the impact of PPEG on survival rates, completed treatment rates and nutritional status of patients with NPC stage II-IV treated with CCRT. Methods: All of the computerized medical records of NPC stage II-IV patients treated with CCRT from January 01, 2007 till September 30, 2011 in Songklanagarind hospital were retrospectively reviewed. The PPEG was done at the discretion of attending physicians. Prophylaxis PEG is defined as PEG placement before CCRT in patients without baseline severe malnourished (BMI! 18.5 kg/m). The three-year overall survival rates, completed treatment rates (CTR) and nutritional status (body weight) during CCRT between PPEG group and Non-PPEG group were compared. PEG utility rate and PEG related complications (PC) were analyzed. PEG related complications were classified as early (! 2 weeks) and late (R 2 weeks) after procedure and severe complications were defined as complications that needed hospitalization. Results: Two hundred and ninety two patients (216 males, 76 females with the mean age 48.7 13.7 years) were enrolled, 192 (65%) patients were classified as PPEG group and 100 patients were classified as Non-PPEG group. The demographic data, tumor staging and ECOG score were similar between the 2 groups. The three-year overall survival rates in PPEG and Non-PPEG group were not significantly different. The mean weight reduction in the Non-PPEG were significantly higher than in the PPEG group during weeks 4-7 of CCRT and the proportion of patients with O10% weight reduction in Non-PPEG were significantly higher than in the PPEG group during weeks 4-7 of CCRT. The PPEG group showed a trend of having a higher CTR than the Non-PPEG group (94.3% vs 87% (P Z 0.055)). PEG related complications occurred in 44 patients (23%), 2 with early and 42 with late complications, and severe complications were observed in 6 patients (3.1%). 161 of 192 patients (83.8%) were available for interview and PEG utility rate as the route of feeding during CCRT was 96.3% (155/161). Conclusion: PPEG lessened weight loss in NPC patients undergoing CCRT and showed a trend in improving the completed treatment rate with minimal serious complications.