Basic Treatment Planning

Pre Radiotherapy Process Percutaneous Endoscopic Gastrostomy

• Consider Elective PEG placement:

Significant weight loss at Dx (>10% in 6 mts)

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Baseline Swallowing Difficulty due to tumour

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 Extensive resection resulting in impaired tongue mobility or swallowing function or

Large Radiotherapy Fields ie bilateral RT

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Chemotherapy

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 No role for elective PEG tubes for all H+N patients due to the 2% mortality rate and up to 8% major complication rate associated with PEG tubes