Malnutrition is common in head and neck cancer (HNC) patients. The acute toxicities of treatment can impact on oral intake and lead to significant weight loss. Prophylactic insertion of gastrostomy feeding tubes aims to provide adequate nutrition and hydration during periods of poor oral intake. However, tube insertion practices are inconsistent due to notions that prophylactic gastrostomy insertions lead to tube dependency and hence impact on swallowing outcomes. The aim of this study is to investigate the prevalence of gastrostomy tube dependence, factors that may prolong tube feeding duration and any late effects associated with longer term tube feeding in HNC patients undergoing radiotherapy (RT)+/-chemotherapy (CT) at Liverpool Cancer Therapy Centre (LCTC). All HNC patients undergoing RT+/-CT who were tube fed during treatment (prophylactic gastrostomy tube or nasogastric tube inserted reactively) at LCTC between January 2010 and December 2012 were included in this retrospective study. Two groups (tube fed for <90 days and tube fed for >90 days) were compared for patient characteristics, and nutritional and clinical outcomes. The prevalence of gastrostomy dependence and complications were also reported. A total of 49 patients met the inclusion criteria. The median weight loss during treatment was 8.3% (IQR 4.4-11.2%). The median tube feeding duration was 96 days (IQR 56-189). Longer tube feeding duration was seen in patients of culturally and linguistically diverse (CALD) backgrounds (P=0.035), patients who had RT alone (P=0.015) and patients who had pre-existing dysphagia prior to treatment (P=0.015). Four (9.8%) and 2 (4.9%) patients were gastrostomy dependent at 1 and 2 years post treatment respectively. Nutrition parameters on treatment completion and tube feeding route were not predictors of tube feeding duration. Future investigations should focus on determining reasons for longer tube feeding duration in CALD patients and identifying areas for practice change to assist this group.