Long-term Swallow Function after Chemoradiotherapy for Oropharyngeal Cancer: The Influence of a Prophylactic Gastrostomy or Reactive Nasogastric Tube

• Published in: Clinical oncology (Royal College of Radiologists (Great Britain)) 2014-02, Vol.26 (2), p.103-109
• Main Authors: Prestwich, R.J.D, Teo, M.T.W, Gilbert, A, Williams, G, Dyker, K.E, Sen, M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Chemoradiotherapy; Cohort Studies; Deglutition - drug effects; Deglutition - physiology; Deglutition - radiation effects; Enteral Nutrition - methods; Female; gastrostomy; Gastrostomy - methods; Hematology, Oncology and Palliative Medicine; Humans; Intubation, Gastrointestinal - methods; Male; Middle Aged; nasogastric tube; Oropharyngeal Neoplasms - drug therapy; Oropharyngeal Neoplasms - physiopathology; Oropharyngeal Neoplasms - radiotherapy; Oropharyngeal Neoplasms - therapy; oropharynx cancer; Radiology; swallow; toxicity; Treatment Outcome
• ISSN: 0936-6555; 1433-2981
• DOI: 10.1016/j.clon.2013.10.005

Abstract Aims Two contrasting approaches of a prophylactic gastrostomy or a nasogastric tube as needed are widely used to support patients receiving chemoradiotherapy for head and neck cancer. The influence of the type and timing of enteral feeding tube support upon long-term swallowing is uncertain. This study analysed the patients' perspective on long-term swallowing, comparing two groups of patients who received chemoradiotherapy for oropharyngeal cancer managed with the two approaches. Materials and methods The MD Anderson Dysphagia Inventory (MDADI) was posted to 63 consecutive patients with oropharyngeal squamous cell cancer treated with concurrent chemoradiotherapy between January 2007 and June 2009, who had not required therapeutic enteral feeding before treatment and who were disease free on follow-up at least 2 years after treatment. Results In total, 56/63 patients completed questionnaires; 43 had been managed with a prophylactic gastrostomy and 13 with a policy of nasogastric tube as needed. There were no significant differences in all global, emotional, physical or functional domains of the MDADI according to enteral feeding strategy. Diet at 6 months after treatment was significantly correlated with better MDADI scores. Conclusions In this study, the choice of a prophylactic gastrostomy or nasogastric tube as needed did not seem to influence long-term swallowing function.