title: Swallowing outcomes for patients with oropharyngeal squamous cell carcinoma treated with primary (chemo)radiation therapy receiving either prophylactic gastrostomy or reactive nasogastric tube: A prospective cohort study.
abstract: OBJECTIVE
  There is currently no consensus on the optimal feeding route for an oropharyngeal squamous cell cancer (OPSCC) patient without pre-existing dysphagia undergoing chemoradiotherapy. This study aimed to compare the swallowing outcomes for OPSCC patients fed via either prophylactic RIG (pRIG) or reactive nasogastric tube (rNGT).
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Four head and neck cancer centres in the North of England Cancer Network.
  
  
  METHODS
  Fifty-three participants with OPSCC, on a normal diet pre-(chemo) radiotherapy.
  
  
  METHODS
  Swallowing outcomes for patients with rNGT and pRIG were compared using the following outcome measures administered prospectively at pre-treatment, three and 12 months post-treatment: MD Anderson Dysphagia Inventory (MDADI), Performance Status Scales (Normalcy of Diet), timed water swallow test.
  
  
  RESULTS
  Twenty-three patients received pRIG while 30 were planned for a rNGT. No differences in demographics were found between the groups. The rNGT group had a clinically significant higher score on MDADI at 12 months post-treatment. No significant difference was found on a timed water swallow test or diet texture scale.
  
  
  CONCLUSIONS
  There is no statistical difference for swallowing outcomes in either group. However, patients' in the rNGT group reported a clinically meaningful difference at 1 year, with a trend for them to do better across all measures. Neither group returned to their baseline swallowing function. Further research with a larger sample size is indicated.
authors.affiliation: Otolaryngology-Head and Neck Surgery, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK.
authors.forename: D
authors.identifier: http://orcid.org/0000-0002-0973-8269
authors.initials: D
authors.lastname: Goff
authors.affiliation: Otolaryngology-Head and Neck Surgery, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK.
authors.forename: S
authors.initials: S
authors.lastname: Coward
authors.affiliation: Otolaryngology-Head and Neck Surgery, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK.
authors.forename: A
authors.initials: A
authors.lastname: Fitzgerald
authors.affiliation: Otolaryngology-Head and Neck Surgery, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK.
authors.forename: V
authors.identifier: http://orcid.org/0000-0002-7933-4585
authors.initials: V
authors.lastname: Paleri
authors.affiliation: ENT Department, Leeds Teaching Hospitals NHS Trust, Leeds.
authors.forename: J W
authors.identifier: http://orcid.org/0000-0002-4399-0572
authors.initials: JW
authors.lastname: Moor
authors.affiliation: Institute of Health and Society Newcastle University, UK.|Speech and Language Therapy Dept, City Hospitals Sunderland NHS Foundation Trust.
authors.forename: J M
authors.initials: JM
authors.lastname: Patterson
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D015331:Cohort Studies; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
keywords: chemoradiotherapy; dysphagia; gastrostomy; head and neck cancer; nasogastric tube