title: Outcomes after the use of gastrostomy tubes in patients whose head and neck cancer was managed with radiation therapy.
abstract: BACKGROUND
  The purpose of this study was to examine the effect of continued oral intake and duration of gastrostomy tube placement on posttreatment nutritional outcomes in patients being irradiated for head and neck cancer.
  
  
  METHODS
  Factors associated with continued oral intake and its association with posttreatment outcomes were analyzed.
  
  
  RESULTS
  Patients with no oral intake (39.6% of 91) were more likely to have laryngeal tumors, advanced disease, and pretreatment gastrostomy tube placement. Of the 55 patients whose gastrostomy tubes had been removed, those with continued oral intake and shorter gastrostomy tube placement were more likely to maintain their weight and report eating scores in the higher-functioning category, but have more restricted diets. Observed survival was significantly better for the continued-oral-intake group (p = .001).
  
  
  CONCLUSIONS
  The beneficial effects of continued oral intake and shorter gastrostomy tube placement on posttreatment outcomes shown in this study suggest that clinicians involved in these patients' care should emphasize oral intake during treatment.
authors.affiliation: University of Iowa College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Ames
authors.forename: Lucy Hynds
authors.initials: LH
authors.lastname: Karnell
authors.forename: Anjali K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Todd C
authors.initials: TC
authors.lastname: Coleman
authors.forename: Michael P
authors.initials: MP
authors.lastname: Karnell
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Van Daele
authors.forename: Gerry F
authors.initials: GF
authors.lastname: Funk
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D004435:Eating; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000150:complications; D016019:Survival Analysis; D013997:Time Factors; D015431:Weight Loss