The target population will be patients with stage III and IV HNSCC who receive primary CRT with curative intent.
Inclusion criteria:
(1) Grade 1 pre-treatment dysphagia, as defined by Common Terminology Criteria for Adverse Events v4.0 (defined as asymptomatic/symptomatic/able to eat regular diet). (2) Consent to be randomised.
Exclusion criteria:
Patients who (1) decline to participate, (2) are unable to give informed consent, (3) cannot receive a gastrostomy for medical reasons, (4) do not receive treatment with curative intent and (5) patients with malnutrition requiring immediate initiation of enteral feeding.
Clinical experience suggests that patients with primary sites in the oropharynx, larynx, nasopharynx and unknown primaries are those who will fulfil the inclusion criteria (~35 to 40 % of all HNSCC patients).
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