The impact of enteral feeding route on patient-reported long term swallowing outcome after chemoradiation for head and neck cancer

Prospective evidence suggests that the selection of feeding tube during chemoradiation (CRT) indirectly affects swallowing outcome. This study explores the patients' perspective on long-term swallowing ability comparing these two feeding routes. Two groups, receiving nutritional supplementation via a prophylactic gastrostomy tube (group G) and by the oral route or via a nasogastric tube (group NG) during CRT, disease-free at >= 24 months following treatment were matched for age, site and stage of tumour. Patient-reported swallowing outcomes for both groups were assessed using the MD Anderson Dysphagia Inventory (MDADI). Group G consisted of 16 patients and group NG of 15 patients. There was statistically significant difference in MDADI scores between the two groups in all domains of the questionnaire (p < 0.001), with superior outcomes in group NG. Use of gastrostomy tubes during CRT conferred a worse swallowing outcome in the long term in this tightly matched cohort of patients. (C) 2011 Elsevier Ltd. All rights reserved.