title: Factors associated with gastrostomy tube dependence after concurrent chemoradiotherapy for hypopharyngeal cancer.
abstract: OBJECTIVE
  We aimed to identify tumor- and treatment-related factors predicting gastrostomy tube dependence after concurrent chemoradiotherapy (CCRT) for hypopharyngeal cancer.
  
  
  METHODS
  We performed a retrospective review of all patients with hypopharyngeal cancer treated with CCRT between 2002 and 2012 except for those with residual or recurrent disease at evaluation. The incidence of gastrostomy tube dependence, defined as complete or almost complete dependence on tube feeding, at 6 months after the completion of treatment was the endpoint. A total of 75 patients were analyzed in this study.
  
  
  RESULTS
  Twelve patients (16 %) showed gastrostomy tube dependence. Among tumor-related factors, the subsite (posterior wall versus pyriform sinus plus postcricoid) was the most significant factor correlated with gastrostomy tube dependence (p < 0.01 by multivariate analysis). The T category of the primary tumor was also correlated with gastrostomy tube dependence on univariate analysis (p < 0.01). Among treatment-related factors, the radiation dose was not associated with gastrostomy tube dependence. On the other hand, gastrostomy tube dependence was also correlated with the requirement of supportive nutrition with a nasogastric tube at the beginning of and during treatment (both p < 0.01).
  
  
  CONCLUSIONS
  Risk factors for gastrostomy tube dependence after the completion of CCRT for hypopharyngeal cancer were identified.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan, murono@med.kanazawa-u.ac.jp.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Murono
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuji
authors.forename: Kazuhira
authors.initials: K
authors.lastname: Endo
authors.forename: Satoru
authors.initials: S
authors.lastname: Kondo
authors.forename: Naohiro
authors.initials: N
authors.lastname: Wakisaka
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Yoshizaki
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D059248:Chemoradiotherapy; D003680:Deglutition Disorders / Q000473:pathology; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects*; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D015994:Incidence; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome