Exploring G‐Tube Timing and Clinical Outcomes in Patients With Locally Advanced Squamous Cell Carcinoma of the Head and Neck Receiving Chemoradiation

BACKGROUND: G-tube placement timing remains poorly characterized in patients with localized head and neck cancer (HNSCC) undergoing definitive chemoradiation (dCRT). METHODS: We retrospectively analyzed 144 patients with HNSCC who received dCRT (2019-2024), categorized by "upfront" or "as-needed" G-tube strategy, to explore factors associated with timing and outcomes using propensity score weighting. RESULTS: Most patients were White (85%) and male (83%); median age was 63 years. Upfront G-tube placement occurred in 60 patients (42%) and was more common among women (64% vs. 37%, p = 0.015) and those with dysphagia (55% vs. 28%, p = 0.001) or receiving induction chemotherapy (71% vs. 38%, p = 0.023). dCRT duration, weight loss, ED visits, hospitalizations, ICU admissions, and survival did not differ. Upfront placement was associated with lower odds of chemotherapy modification (73% lower, p = 0.007) and fewer infusion clinic visits (average 3 fewer, p = 0.038). CONCLUSION: These findings suggest multiple factors influence G-tube timing and outcomes, warranting prospective validation.