title: Efficacy of percutaneous endoscopic gastrostomy on unplanned treatment interruption and nutritional status in patients undergoing chemoradiotherapy for advanced head and neck cancer.
abstract: OBJECTIVE
  Efficacy of percutaneous endoscopic gastrostomy (PEG) on unplanned treatment interruption and nutritional status was examined in patients undergoing chemoradiotherapy (CRT) for advanced head and neck cancer.
  
  
  METHODS
  We retrospectively reviewed hospital charts of 44 patients with advanced head and neck cancer who were treated with CRT.
  
  
  RESULTS
  CRT-induced mucositis of grade 3 or worse and inadequate oral intake of less than one third of their usual intake developed in 33 patients who were recommended PEG placement, but not in 11 patients. Thirteen patients accepted PEG placement and then completed CRT (compliant group). However, among 20 patients who refused both PEG and nasogastoric tube (NGT) placements (non-compliant group), 10 required unplanned interruptions of CRT at a radiation dose around 30-40 Gy (UI-CRT group) while 10 others could complete CRT without interruption (C-CRT group) CRT. Total serum protein levels were significantly decreased after CRT in all patients.
  
  
  CONCLUSIONS
  It is suggested that therapeutic PEG placement is useful for preventing unplanned interruption of CRT in patients with advanced head and neck cancer. After severe mucositis and inadequate oral intake have developed during CRT, PEG placement should be considered before the radiation therapy dose of 30 Gy.
authors.affiliation: Department of Otolaryngology, University of Tokushima School of Medicine.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Goda
authors.forename: Osamu
authors.initials: O
authors.lastname: Jinnouchi
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Takaoka
authors.forename: Koji
authors.initials: K
authors.lastname: Abe
authors.forename: Koich
authors.initials: K
authors.lastname: Tamura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nakaya
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Furukita
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takechi
authors.forename: Akira
authors.initials: A
authors.lastname: Tangoku
authors.forename: Noriaki
authors.initials: N
authors.lastname: Takeda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000009:adverse effects; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000378:metabolism / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012189:Retrospective Studies