Benefits of prophylactic percutaneous gastrostomy in patients with nasopharyngeal cancer receiving concurrent chemoradiotherapy: A multicenter analysis
Issued Date
2022-03-01
Resource Type
ISSN
01960709
eISSN
1532818X
Scopus ID
2-s2.0-85122091399
Pubmed ID
34972008
Journal Title
American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume
43
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Otolaryngology - Head and Neck Medicine and Surgery Vol.43 No.2 (2022)
Suggested Citation
Dechaphunkul T. Benefits of prophylactic percutaneous gastrostomy in patients with nasopharyngeal cancer receiving concurrent chemoradiotherapy: A multicenter analysis. American Journal of Otolaryngology - Head and Neck Medicine and Surgery Vol.43 No.2 (2022). doi:10.1016/j.amjoto.2021.103356 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86094
Title
Benefits of prophylactic percutaneous gastrostomy in patients with nasopharyngeal cancer receiving concurrent chemoradiotherapy: A multicenter analysis
Author(s)
Other Contributor(s)
Abstract
Purpose: Prophylactic percutaneous endoscopic gastrostomy (PPEG) is widely used for patients with head and neck cancer undergoing concurrent chemoradiation (CCRT). Nevertheless, the necessity of its use in patients with nasopharyngeal cancer (NPC) is uncertain. This study aimed to evaluate the benefits of PPEG on prevention of weight loss and treatment tolerance in patients with NPC receiving CCRT. Materials and methods: A retrospective multicenter chart review of 904 patients, 378 in the PPEG group and 526 in the non-PPEG group, was conducted. Baseline characteristics, weight loss, and treatment tolerance were analyzed and compared between the two groups. Results: There was no significant difference in the mean baseline body mass index (BMI) between the groups. At the end of CCRT, no difference in weight loss was found between the 2 groups (non-PPEG group, 6.6%; PPEG group, 5.9%). Nonetheless, the subgroup analysis demonstrated that a baseline BMI < 18.5 kg/m2 (underweight) and non–intensity-modulated radiation therapy (IMRT) technique were independent factors associated with prevention of weight loss by PPEG. More patients in the PPEG group were able to complete planned cycles of chemotherapy (73.3% vs. 49.0%, P < .0001). Conclusion: Although the benefits of PPEG on prevention of weight loss were not observed for the entire cohort, we found a potentially protective effect of PPEG in some subgroups of patients. Additionally, PPEG significantly enhanced chemotherapy tolerance. Therefore, PPEG tube insertion should be strongly considered for patients with NPC receiving CCRT, particularly for underweight patients and those undergoing a non-IMRT technique.