Factors associated with gastrostomy tube dependence after concurrent chemoradiotherapy for hypopharyngeal cancer

Support Care Cancer. 2015 Feb;23(2):457-62. doi: 10.1007/s00520-014-2388-8. Epub 2014 Aug 17.

Abstract

Purpose: We aimed to identify tumor- and treatment-related factors predicting gastrostomy tube dependence after concurrent chemoradiotherapy (CCRT) for hypopharyngeal cancer.

Methods: We performed a retrospective review of all patients with hypopharyngeal cancer treated with CCRT between 2002 and 2012 except for those with residual or recurrent disease at evaluation. The incidence of gastrostomy tube dependence, defined as complete or almost complete dependence on tube feeding, at 6 months after the completion of treatment was the endpoint. A total of 75 patients were analyzed in this study.

Results: Twelve patients (16 %) showed gastrostomy tube dependence. Among tumor-related factors, the subsite (posterior wall versus pyriform sinus plus postcricoid) was the most significant factor correlated with gastrostomy tube dependence (p < 0.01 by multivariate analysis). The T category of the primary tumor was also correlated with gastrostomy tube dependence on univariate analysis (p < 0.01). Among treatment-related factors, the radiation dose was not associated with gastrostomy tube dependence. On the other hand, gastrostomy tube dependence was also correlated with the requirement of supportive nutrition with a nasogastric tube at the beginning of and during treatment (both p < 0.01).

Conclusion: Risk factors for gastrostomy tube dependence after the completion of CCRT for hypopharyngeal cancer were identified.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery*
  • Chemoradiotherapy
  • Deglutition Disorders / pathology
  • Enteral Nutrition / adverse effects*
  • Female
  • Gastrostomy / adverse effects*
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Hypopharyngeal Neoplasms / drug therapy
  • Hypopharyngeal Neoplasms / radiotherapy
  • Hypopharyngeal Neoplasms / surgery*
  • Incidence
  • Intubation, Gastrointestinal / adverse effects*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Squamous Cell Carcinoma of Head and Neck
  • Treatment Outcome