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Prophylactic Gastrostomy before Chemoradiation in Advanced Head and Neck Cancer: a Multiprofessional Web-based Survey to Identify Current Practice and to Analyse Decision Making

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

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Abstract

Aims: Patients with advanced squamous carcinoma of the head and neck who are treated with concurrent chemoradiotherapy schedules are often referred for gastrostomy tube (G-tube) insertion. Decision making to select appropriate patients is inconsistent and the factors that lead healthcare workers to make this recommendation are not well understood. Therefore, by means of a web-based questionnaire we sought the views of a variety of healthcare professionals as to their current practice with regard to various issues surrounding the recommendation of G-tube insertion use in these patients and analysed the responses with regard to decision making. Materials and methods: Questions were generated after discussion among and agreement from all members of a single National Health Service Trust head and neck multidisciplinary team and were hosted on a website. Appropriate individuals were identified through their governing body organisations and invited by e-mail to complete the questionnaire. The results were pooled and analysed. Results: Recommendations for gastrostomy were not based on tumour subsite. Four of 14 patient-related factors were significantly associated with the recommendation for gastrostomy. Medical and allied healthcare professionals (including nursing staff) significantly differed in their opinions as to the effect of G-tubes on the resumption of oral intake (P = 0.009). Conclusions: There is no national consensus on which patients to recommend for gastrostomy and consideration should be given to the development of clinical decision-making models in an attempt to systematise the decision-making process. (C) 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Publication metadata

Author(s): Moor JW, Patterson J, Kelly C, Paleri V

Publication type: Article

Publication status: Published

Journal: Clinical Oncology

Year: 2010

Volume: 22

Issue: 3

Pages: 192-198

Print publication date: 01/04/2010

ISSN (print): 0936-6555

ISSN (electronic): 1433-2981

Publisher: Elsevier Ltd

URL: http://dx.doi.org/10.1016/j.clon.2010.01.008

DOI: 10.1016/j.clon.2010.01.008

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