Role of intensive nutrition support and prophylactic percutaneous endoscopic gastrostomy during concomitant chemoradiotherapy for oropharyngeal cancer

Background Concomitant chemoradiotherapy (CCRT) produces severe mucositis and swallowing dysfunction, often resulting in malnutrition. Intensive nutrition support (INS) in addition to percutaneous endoscopic gastrostomy (PEG) is reported to decrease adverse effects during CCRT. Patients and Methods Fifty-eight patients with oropharyngeal cancer treated by CDDP-based CCRT were retrospectively analyzed. Twenty-nine patients treated with INS in addition to PEG were classified as INS group, and other 29 patients treated with PEG but without INS were classified as control group. Results INS in addition to PEG significantly increased calorie intake in the second half of CCRT and reduced adverse events including mucositis (p=0.0019), leukopenia (p=0.04), and renal function (p=0.006). Moreover, 21 out of 29 patients had successfully administration of 200mg/m2 or more of CDDP, while only 10 out of 29 patients had enough amount of CDDP in control group. Conclusions These results suggest that INS in addition to prophylactic PEG not only decreases adverse effects but also may potentially improve oncological outcome of the patients with oropharyngeal cancer treated by CCRT.