title: Impact of prophylactic gastrostomy or reactive NG tube upon patient-reported long term swallow function following chemoradiotherapy for oropharyngeal carcinoma: A matched pair analysis.
abstract: The purpose of this matched pair analysis is to assess patient-reported long term swallow function following chemoradiotherapy for locally advanced oropharyngeal cancer in relation to the use of a prophylactic gastrostomy or reactive nasogastric (NG) tube.
  
  
  
  The MD Anderson Dysphagia Inventory (MDADI) was posted to 68 consecutive patients with stage III/IV oropharyngeal squamous cell carcinoma who had completed parotid sparing intensity modulated radiotherapy with concurrent chemotherapy between 2010 and 2012, had not required therapeutic enteral feeding prior to treatment, minimum 2years follow up post treatment, and who were disease free. 59/68 replies were received, and a matched pair analysis (matching for T and N stage) was performed for 52 patients, 26 managed with a prophylactic gastrostomy and 26 with an approach of an NG tube as needed.
  
  
  
  There were no significant differences in patient demographics, pre-treatment diet and treatment factors between the two groups. Patient-reported swallowing function measured using the MDADI was superior for patients managed with an NG tube as required compared with a prophylactic gastrostomy: overall composite score 68.1 versus 59.4 (p=0.04), global score 67.7 versus 60 (p=0.04), emotional subscale 73.5 versus 60.4 (p<0.01), functional subscale 75.4 versus 61.7 (p<0.01), and physical subscale 59.6 versus 57.1 (p=0.38).
  
  
  
  Compared with an approach of an NG tube as required, the use of a prophylactic gastrostomy was associated with inferior long term patient-reported long term swallow outcomes.
authors.affiliation: Department of Clinical Oncology, Leeds Cancer Centre, St. James's Institute of Oncology, Leeds, UK.
authors.forename: Brinda
authors.initials: B
authors.lastname: Sethugavalar
authors.affiliation: Department of Clinical Oncology, Leeds Cancer Centre, St. James's Institute of Oncology, Leeds, UK.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Teo
authors.affiliation: Department of Radiotherapy, Leeds Cancer Centre, St. James's Institute of Oncology, Leeds, UK.
authors.forename: Catriona
authors.initials: C
authors.lastname: Buchan
authors.affiliation: Department of Clinical Oncology, Leeds Cancer Centre, St. James's Institute of Oncology, Leeds, UK.
authors.forename: Ekin
authors.initials: E
authors.lastname: Ermiş
authors.affiliation: Dietetic Department, Leeds Cancer Centre, St. James's Institute of Oncology, Leeds, UK.
authors.forename: Gillian F
authors.initials: GF
authors.lastname: Williams
authors.affiliation: Department of Clinical Oncology, Leeds Cancer Centre, St. James's Institute of Oncology, Leeds, UK.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sen
authors.affiliation: Department of Clinical Oncology, Leeds Cancer Centre, St. James's Institute of Oncology, Leeds, UK. Electronic address: Robin.Prestwich@nhs.net.
authors.forename: Robin J D
authors.initials: RJD
authors.lastname: Prestwich
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003680:Deglutition Disorders / Q000628:therapy*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000628:therapy*; D012189:Retrospective Studies
keywords: Chemotherapy; Gastrostomy; Head and neck cancer; Late toxicity; Nasogastric tube; Oropharynx cancer; Quality of life; Radiotherapy; Swallow