title: Gastrostomy in head and neck cancer: current literature, controversies and research.
abstract: OBJECTIVE
  This article explores the literature on the role of gastrostomy tube feeding use in the management of head and neck cancer, with special attention to its indications, timing of insertion, advantages, complications and quality of life issues.
  
  
  RESULTS
  The current guidelines in place across different countries and two ongoing randomized controlled trials are discussed in detail, and placed in the context of current evidence.
  
  
  CONCLUSIONS
  There remains a lack of consensus about when and which enteral feeding routes (gastrostomy or nasogastric tube) should be used and controversy about the long-term effects on swallowing function as well as quality of life for patients. Local guidelines should be used or generated to guide practice or patients enrolled into existing trials until higher level evidence is generated.
authors.affiliation: aDepartment of Otolaryngology, Northern Deanery, Newcastle Upon Tyne, UK bDepartment of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia cDepartment of Otolaryngology-Head and Neck Surgery, Newcastle Upon Tyne Foundation Hospitals NHS Trust, Newcastle Upon Tyne, UK.
authors.forename: Paula T
authors.initials: PT
authors.lastname: Bradley
authors.forename: Teresa
authors.initials: T
authors.lastname: Brown
authors.forename: Vinidh
authors.initials: V
authors.lastname: Paleri
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004750:Enteral Nutrition; D005774:Gastrostomy / Q000009:adverse effects*; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects* / Q000379:methods*