Title: A comparison of gastrostomy tube insertion in head and neck cancer patients at SIVUH with UK National MDT Guidelines.

Background: Patients with head and neck cancer (HNC) are at increased risk of malnutrition due to tumour location and treatment. Enteral feeding is common practice in HNC. Prophylactic gastrostomy tubes (pPEG) are often placed prior to radiotherapy treatment, however, practice varies worldwide. Recently published UK multidisciplinary (MDT) guidelines on the management of HNC (2024) outline gastrostomy tube selection criteria. This project aims to assess if patients met the selection criteria for pPEG insertion at South Infirmary Victoria University Hospital (SIVUH). Methods: Data were collected retrospectively on patients that had a gastrostomy tube inserted at SIVUH between 2021-2024. Dietetic record cards enabled the identification of patient demographics, nutritional status, reason for gastrostomy insertion and duration of use. Results: A total of 151 gastrostomy tubes were inserted in SIVUH from 2021-2024, 53 of these placed prophylactically. Based on 2023/2024 data, 81% of patients had dysphagia and 60% of patients had >5% weight loss before gastrostomy tube placement with 16% of patients experiencing no weight loss. Preliminary analysis suggests patients that had a pPEG inserted met the selection criteria. Conclusion: This project measured compliance of pPEG insertion with the UK MDT selection criteria. Findings suggest that there is appropriate patient selection for pPEG and these criteria are actively considered by the MDT at SIVUH.