Abstract

Introduction: The benefits of prophylaxis percutaneous endoscopic gastrostomy (PPEG) in term of survival and nutritional status in nasopharyngeal cancer (NPC) are still unknown. This study aim is to assess the impact of PPEG on the survival rate, completed treatment rate (CTR), and the nutritional status of patients with NPC stage II-IV, having been treated with concurrent chemo-radiation therapy (CCRT).

Material and Methods:  All of the computerized medical records of NPC stage II-IV patients treated with CCRT, without severe malnourishment (BMI < 18.5 kg/m2) from; January 2007 to September 2011 were retrospectively reviewed. PPEG is defined as PEG tube placement prior to CCRT. The 1- and 3-year overall survival rates, completed treatment rate and nutritional status (body weight) during CCRT, between the PPEG group and the non-PPEG group, were compared. PEG utility rate and PEG related complications were collected.

Results: Two hundred and ninety two patients (216 males, 76 females, with the mean age being 48.7 + 13.7 years) were enrolled, 192 (65%) in the PPEG group, and 100 patients in the non-PPEG group. The demographic data, tumor staging, and ECOG scores were similar between the 2 groups, and the 3-year overall survival rates of the PPEG and non-PPEG group were not significantly different. Mean weight reduction, and the proportion of patients with >10% weight reduction in the non-PPEG was significantly higher 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 = 0.055)). In the group of PPEG, PEG related complications occurred in 44 patients (23%) and severe complications were observed in 6 patients (3.1%). The utility rate of gastrostomy tube, as the route of feeding during CCRT, was 96.3% (155/161).

Conclusion:  PPEG lessened weight reduction in NPC patients, stage II-IV during CCRT, and showed a trend of improving the completed treatment rate with minimal serious complications. However, there was no difference in terms of overall survival.