For patients with head and neck cancer undergoing prophylactic gastrostomy tube (GT) insertion before definitive radiotherapy or chemoradiotherapy, current smoking and current heavy alcohol consumption are predictive of prolonged GT requirements, according to a study published in JAMA Otolaryngology-Head & Neck Surgery.

Ross O’Shea, M.B., from the South Infirmary Victoria University Hospital in Cork, Ireland, and colleagues examined the duration of GT use in patients with head and neck cancer who were undergoing definitive treatment with chemoradiotherapy (84 patients) or radiotherapy alone (20 patients).

The researchers found that the median duration of GT use was nine months; at one year, the actuarial GT persistence was 35 percent.

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Significant predictors of GT persistence, according to univariate analysis of factors predictive of GT removal, were current smoking (hazard ratio, 0.47; P = 0.01) and current heavy alcohol consumption (hazard ratio, 0.55; P = 0.04).

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Only current smoking remained significant on multivariate analysis (hazard ratio, 0.53; P = 0.03). Advanced age (65 years or older), advanced T classification, larynx and/or hypopharynx primary site, and post-treatment neck dissection were not found to be significant risk factors.

“Further study is required to investigate whether smoking or drinking cessation can reduce GT dependence rates in this population,” the authors write.


  1. O’Shea, Ross, MB, et al. “Impact of Current Smoking and Alcohol Consumption on Gastrostomy Duration in Patients With Head and Neck Cancer Undergoing Definitive Chemoradiotherapy.” JAMA Otolaryngology – Head & Neck Surgery. doi:10.1001/jamaoto.2015.0279. March 19, 2015.