The risk categories in the guidelines are valid to assist early identification of swallowing and nutritional risk and guide decision-making on proactive gastrostomy tube insertion.

Prophylactic gastrostomy tubes in patients with high-risk head and neck cancer resulted in a significant decrease in hospital admissions and length of stay, and led to increased bed availability.

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Tracheostomy training and support in the UK What this paper adds What is already known on this subject?Literature regarding the education, training, clinical support and confidence of Speech Language Therapists (SLTs) working with patients with a tracheostomy is scarce. However, it suggests that many SLTs have reduced clinical confidence regarding managing this complex population, many face role and team challenges practicing in this area, and most are seeking more opportunities for professional development and training. What this study addsThe purpose of the current study was to investigate the preparation, training, extent of clinical support and confidence of SLTs involved in the care of patients with a tracheostomy in the UK. Although the issues facing clinicians in the UK have not been previously reported, many of the issues identified were found to be similar to those reported 6 years previously for Australian clinicians (Ward et al. 2008). This earlier work and the current findings highlight ongoing challenges facing clinicians managing the tracheostomy population and provide directions for future professional development and training activities. The current data also highlights potential benefits that can be achieved from competency training in tracheostomy.

SLTs in the UK provide a moderate to high level of consistent practice in tracheostomy management. This study identifies areas of tracheostomy management that require further research in order to establish clinical practice guidelines and to address discrepancies between research evidence and clinical implementation.

Minor modifications to the high risk definition in the guidelines have improved the guideline sensitivity for future use. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1163-E1171, 2016.

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Results confirm that patients with oropharyngeal SCC undergoing helical IMRT with chemotherapy continue to experience incidences of acute toxicities comparable with other conformal techniques, and need supportive cares.