A Retrospective Study of G-Tube Use in Japanese Patients Treated with Concurrent Chemoradiotherapy for Hypopharyngeal Cancer

• Published in: PloS one Vol. 11; no. 8; p. e0161734
• Main Authors: Homma, Akihiro, Hatakeyama, Hiromitsu, Mizumachi, Takatsugu, Kano, Satoshi, Sakashita, Tomohiro, Kuramoto, Rinnosuke, Nakamaru, Yuji, Onimaru, Rikiya, Tsuchiya, Kazuhiko, Yoshida, Daisuke, Yasuda, Koichi, Shirato, Hiroki, Fukuda, Satoshi
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.08.2016; Public Library of Science (PLoS)
• Subjects: Aged; Biology and Life Sciences; Cancer; Cancer therapies; Care and treatment; Chemoradiotherapy; Chemoradiotherapy - adverse effects; Chemotherapy; Cisplatin; Deglutition Disorders - etiology; Deglutition Disorders - surgery; Diagnosis; Drug dosages; Dysphagia; Female; Follow-Up Studies; Gastrostomy; Gastrostomy - methods; Head & neck cancer; Health aspects; Humans; Hypopharyngeal Neoplasms - complications; Hypopharyngeal Neoplasms - diagnosis; Hypopharyngeal Neoplasms - mortality; Hypopharyngeal Neoplasms - therapy; Intravenous administration; Japan; Larynx; Lymphatic system; Male; Medicine; Medicine and Health Sciences; Metastasis; Middle Aged; Minority & ethnic groups; Neck; Neoplasm Metastasis; Neoplasm Staging; Ostomy; Otolaryngology; Parenteral nutrition; Patient outcomes; Patients; Pharyngeal cancer; Radiation therapy; Radiotherapy; Retrospective Studies; Smoking; Squamous cell carcinoma; Studies; Surgery; Swallowing; Throat cancer; Toxicity; Treatment Outcome; University graduates; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0161734

Late toxicity after concurrent chemoradiotherapy (CCRT), such as dysphagia, in patients with squamous cell carcinoma of the head and neck has received a good deal of attention recently. The gastrostomy tube (G-tube) dependence rate 1 year after CCRT was reported to be 16.7-42.9% in Western countries. We evaluated swallowing outcomes after CCRT in patients with hypopharyngeal cancer (HPC) treated in our hospital and compared them with previous reports. We reviewed 96 consecutive patients with a HPC treated by radiotherapy with intravenous or intra-arterial chemotherapy between 2006 and 2013 at Hokkaido University Hospital, Sapporo, Japan. At 1 month after CCRT, 13 patients (13.7%) used a G-tube, whereas 5/91 (5.5%) and 4/81 (4.9%) used a G-tube at 3 and 6 months, respectively. Two patients used a G-tube at 12 and 24 months after CCRT (G-tube use rate: 2.8% at 12 months, and 3.2% at 24 months). The variables female, posterior wall primary, stage IV, ECOG performance status of 2, and smoking status were significantly associated with G-tube use at 12 months after CCRT, whereas the route of cisplatin administration was not related to G-tube use (p = 0.303). The G-tube use rate up to 1year could be lower in Japanese patients than in Western patients according to previous reports. In particular, Japanese patients resume oral intake sooner than Western patients. Further study of the incidence of dysphagia after CCRT by ethnicity is required to clarify the differences in dysphagia after CCRT.