title: Gastrostomy dependence in head and neck carcinoma patient receiving post-operative therapy.
abstract: OBJECTIVE
  Post-operative concurrent chemoradiotherapy significantly improves the rates of locoregional control and disease-free survival in high-risk patients but has significant adverse effects. Percutaneous endoscopic gastrostomy and opioid-based pain control increase treatment completion rates but can result in dysphagia.
  
  
  METHODS
  The rate and duration of use of prophylactically placed percutaneous endoscopic gastrostomies were evaluated in 43 patients who underwent post-operative radiotherapy or chemoradiotherapy from April 2007 through March 2010. All patients completed treatment and received 60 Gy or more of radiotherapy.
  
  
  RESULTS
  Thirty four of 43 patients (79.1%) used percutaneous endoscopic gastrostomies, which could later be removed in 25 of 34 patients. The median period of use was 108 days. Only one disease-free patient was permanently dependent on percutaneous endoscopic gastrostomy feeding. The frequency of percutaneous endoscopic gastrostomy use among patients with oral, oropharyngeal and hypopharyngeal cancer was 91.7, 100 and 54.5%, respectively.
  
  
  CONCLUSIONS
  Prolonged percutaneous endoscopic gastrostomy use is not required in patients receiving post-operative chemoradiotherapy and will not lead to dysphagia.
authors.affiliation: Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa tashinoz@east.ncc.go.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shinozaki
authors.affiliation: Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
authors.affiliation: Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyazaki
authors.affiliation: Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tomioka
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa.
authors.forename: Sadamoto
authors.initials: S
authors.lastname: Zenda
authors.affiliation: Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Tahara
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Akimoto
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery / Q000628:therapy*; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D003680:Deglutition Disorders / Q000209:etiology; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004408:Dysgeusia / Q000209:etiology; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000628:therapy; D018714:Radiotherapy, Adjuvant; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: H and N-RadOncol; deglutition training; enteral feeding; nutritional management; post-operative therapy; prophylactic PEG