Assessment of Nutritional Status in Head and Neck Cancer Patients Following Percutaneous Endoscopic Gastrostomy (PEG) Tube Insertion

Background: Patients with head and neck cancer (HNC) are at high risk of malnutrition due to tumor location and treatment-related adverse effects that impair oral intake. Percutaneous endoscopic gastrostomy (PEG) is widely used to provide long-term enteral nutritional support during treatment.

Objective: To evaluate changes in body weight and body mass index (BMI) following PEG insertion among patients with HNC receiving radiotherapy.

Methods: A retrospective cohort study was conducted on 100 HNC patients aged 18–60 years who underwent PEG insertion and received radiotherapy at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Peshawar, between January 1, 2023, and January 1, 2025. Anthropometric data, including weight, height, and BMI, were collected at baseline (immediately after PEG insertion), the second follow-up, and the third follow-up. Repeated-measures analysis of variance (ANOVA) with post hoc comparisons was performed using SPSS version 25. Statistical significance was set at p < 0.05.

Results: The mean age of participants was 46.5 ± 11.2 years. Mean body weight decreased from 60.9 ± 14.1 kg at baseline to 58.2 ± 13.9 kg and 56.9 ± 14.0 kg at the second and third follow-ups, respectively. Similarly, mean BMI declined from 22.8 ± 5.1 kg/m² to 21.7 ± 4.8 kg/m² and 21.3 ± 4.7 kg/m². Reductions in both weight and BMI from baseline to the third follow-up were statistically significant (p < 0.05).

Conclusion: Despite PEG-assisted enteral nutrition, patients with HNC experienced significant reductions in body weight and BMI during radiotherapy. These findings highlight the importance of early, individualized nutritional interventions, regular dietetic counseling, and close nutritional monitoring to minimize malnutrition and improve clinical outcomes in this high-risk population.