Does feeding tube placement predict for long‐term swallowing disability after radiotherapy for head and neck cancer?

Abstract

Purpose. To evaluate feeding tube use. Materials and Methods. Nine hundred thirty‐four patients were treated with radiotherapy (RT). Results. Feeding tubes were placed in 235 patients (25%): 212 patients (22.5%) for acute toxicity, 18 patients (2%) for late effects, and 5 patients (0.5%) for both. Median duration of tube dependence for acute toxicity was 3.8 months. Multivariate analysis revealed that feeding tube placement for acute toxicity was increased with higher RT dose (p < .0001), adjuvant chemotherapy (p = .0002), advanced age (p = .0002), and the presence of neck disease (p = .0045). The risk of a feeding tube for late effects was 2% at 5 years. The likelihood of feeding tube placement for late effects was greater for women (p = .0293), higher RT dose (p = .0345), and primary sites, including the hypopharynx and multiple synchronous primary tumors (p = .0360). Feeding tube placement for late effects was unrelated to tube placement for acute toxicity. Conclusion. Likelihood of long‐term feeding tube dependence was low and unrelated to placement for acute effects. © 2003 Wiley Periodicals, Inc. Head Neck 25: 741–747, 2003