Comparison of Treatment Compliance and NutritionalOutcomes among Patients with Nasopharyngeal Carcinoma with and without Percutaneous Endoscopic Gastrostomy during Chemoradiation

Aims: The study aimed to compare treatment compliance and nutritional outcomes in nasopharyngealcarcinoma (NPC) patients during chemoradiation.
Methods: Clinical information of patients with NPC thatunderwent chemoradiation during 2004-2009 were retrieved from the hospital database and retrospectivelyreviewed. Patients were categorised into a prophylactic percutaneous endoscopic gastrostomy (PPEG) groupand a non-PPEG group. Clinical information including treatment compliance, weight, haematological and renaltoxicity was compared.
Results: A total of 219 patients were reviewed and categorised into PPEG (n=77) andnon-PPEG (n=142). Significant differences in absolute percentage weight loss between groups were found fromthe 3rd cycle of chemotherapy. There were 24.2, 20.3 and 24.8% in the third, the fourth and the fifth cycles ofchemotherapy, respectively. Migration of grade 2 to grade 3 weight loss was obviously seen in the 3rd cycle as well.A significant difference of grade 3 or more hypokalemia was found with values of 14.3% and 50% in the PPEGand non-PPEG groups, respectively. Other toxicity parameters and treatment compliance were not differentbetween the groups.
Conclusions: Use of PPEG resulted in decreased severe weight loss, reduced migration fromgrade 2 to grade 3 weight loss and reduced hypokalaemia. However, benefits in treatment compliance could notbe detected. So consideration of PPEG in NPC patients requires care.