Choosing Optimal Feeding Method in Head–Neck Cancer Patients Receiving Radiation: Percutaneous Endoscopic Gastrostomy Versus Nasogastric Tube—Is It Pertinent?

Abstract

The current standard of care for locally-advanced head–neck cancer is multidisciplinary, using bimodality or trimodality therapy as appropriate. These patients are frequently malnourished either due to disease or due to treatment related toxicities. Both chemotherapy and radiotherapy are associated with acute and late toxicities which in turn exacerbate malnutrition in these patients. Malnutrition is found to be associated with poor survival outcomes. To maintain nutrition in such patients, enteral feeding can be done using either percutaneous endoscopic gastrostomy tube (PEG) or a nasogastric tube (NGT). Both PEG and NGT have been found effective in adequate maintenance of weight; however, both have their own set of advantages and disadvantages. Nutritional counselling forms an integral part of weight management during treatment and oral feeding should be encouraged in all unless contra-indicated.