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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

Lookup NU author(s): Diane Goff, Professor Vinidh Paleri, Dr Joanne Patterson

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Abstract

OBJECTIVES: 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).DESIGN: A prospective cohort study.SETTING: Four head and neck cancer centres in the North of England Cancer Network.PARTICIPANTS: Fifty-three participants with OPSCC, on a normal diet pre-(chemo) radiotherapy.MAIN OUTCOME MEASURE: 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.

Publication metadata

Author(s): Goff D, Coward S, Fitzgerald A, Paleri V, Moor JW, Patterson JM

Publication type: Article

Publication status: Published

Journal: Clinical Otolaryngology

Year: 2017

Volume: 42

Issue: 6

Pages: 1135-1140

Print publication date: 01/12/2017

Online publication date: 27/01/2017

Acceptance date: 23/01/2017

ISSN (print): 1749-4478

ISSN (electronic): 1749-4486

Publisher: Wiley-Blackwell Publishing, Inc.

URL: https://doi.org/10.1111/coa.12836

DOI: 10.1111/coa.12836

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