The impact of prophylactic percutaneous endoscopic gastrostomy PEG in head and neck cancer patients treated with radiotherapy The impact of prophylactic PEG in head and neck cancer

Aim: The purpose of this study is to compare the patients with head and neck cancer (HNC) who underwent radiotherapy (RT) with or without prophylactic percutaneous endoscopic gastrostomy (PEG) in terms of weight loss, interruption of treatment, and survival. Material and Methods: The data of 64 patients who were diagnosed with HNC and received RT in our clink between November 2013 and July 2019 were evaluated retrospectively. Only cases with prophylactic PEG were included. Patients in the negative PEG (nPEG) (n:43) and positive PEG (pPEG) (n:21) arms are similar apart from the primary subsite. Results: The median follow-up time was 20 months (range 2- 62 months). The 20-month OS was 76.3% and 58.8% for nPEG and pPEG patients. respectively (p=0.05). Weight loss after RT was higher in the nPEG arm compared to the pPEG arm, but not statistically significant (p=0.18). No significant differences were observed in terms of acute and late adverse effects. There was no significant difference between the duration of RT interruption in patients and the PEG status (p=0.53). Discussion: No significant effect of the nutritional status by prophylactic PEG on weight loss, treatment interruption and oncological outcomes in patients with HNC who underwent RT has been demonstrated. However, well designed, larger studies are needed comparing patients with and without prophylactic enteral tube placement.