Long-term swallow function after chemoradiotherapy for oropharyngeal cancer: the influence of a prophylactic gastrostomy or reactive nasogastric tube.
OBJECTIVE
Two contrasting approaches of a prophylactic gastrostomy or a nasogastric tube as needed are widely used to support patients receiving chemoradiotherapy for head and neck cancer. The influence of the type and timing of enteral feeding tube support upon long-term swallowing is uncertain. This study analysed the patients' perspective on long-term swallowing, comparing two groups of patients who received chemoradiotherapy for oropharyngeal cancer managed with the two approaches.


METHODS
The MD Anderson Dysphagia Inventory (MDADI) was posted to 63 consecutive patients with oropharyngeal squamous cell cancer treated with concurrent chemoradiotherapy between January 2007 and June 2009, who had not required therapeutic enteral feeding before treatment and who were disease free on follow-up at least 2 years after treatment.


RESULTS
In total, 56/63 patients completed questionnaires; 43 had been managed with a prophylactic gastrostomy and 13 with a policy of nasogastric tube as needed. There were no significant differences in all global, emotional, physical or functional domains of the MDADI according to enteral feeding strategy. Diet at 6 months after treatment was significantly correlated with better MDADI scores.


CONCLUSIONS
In this study, the choice of a prophylactic gastrostomy or nasogastric tube as needed did not seem to influence long-term swallowing function.
Department of Clinical Oncology, St James's Institute of Oncology, Leeds, UK. Electronic address: Robin.Prestwich@leedsth.nhs.uk.
R J D
RJ
Prestwich
Department of Clinical Oncology, St James's Institute of Oncology, Leeds, UK.
M T W
MT
Teo
University of Leeds, Leeds, UK.
A
A
Gilbert
Dietetic Department, St James's Institute of Oncology, Leeds, UK.
G
G
Williams
Department of Clinical Oncology, St James's Institute of Oncology, Leeds, UK.
K E
KE
Dyker
Department of Clinical Oncology, St James's Institute of Oncology, Leeds, UK.
M
M
Sen
D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy; D015331:Cohort Studies; D003679:Deglutition / Q000187:drug effects / Q000502:physiology* / Q000528:radiation effects; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000379:methods; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy / Q000628:therapy*; D016896:Treatment Outcome
Chemoradiotherapy; gastrostomy; nasogastric tube; oropharynx cancer; swallow; toxicity