Pretreatment risk stratification of feeding tube use in patients treated with intensity-modulated radiotherapy for head and neck cancer

Nigel J. Anderson; James E. Jackson; Jennifer G. Smith; Morikatsu Wada; Michal Schneider; Michael Poulsen; Maureen Rolfo; Maziar Fahandej; Hui Gan; Daryl Lim Joon; Vincent Khoo

doi:10.1002/hed.25316

Pretreatment risk stratification of feeding tube use in patients treated with intensity-modulated radiotherapy for head and neck cancer

Nigel J. Anderson, James E. Jackson^*, Jennifer G. Smith, Morikatsu Wada, Michal Schneider, Michael Poulsen, Maureen Rolfo, Maziar Fahandej, Hui Gan, Daryl Lim Joon, Vincent Khoo

^*Corresponding author for this work

Faculty of Health Sciences & Medicine

Research output: Contribution to journal › Article › Research › peer-review

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Abstract

Background: The purpose of this study was to establish a risk stratification model for feeding tube use in patients who undergo intensity-modulated radiotherapy (IMRT) for head and neck cancers.

Methods: One hundred thirty-nine patients treated with definitive IMRT (+/- concurrent chemotherapy) for head and neck mucosal cancers were included in this study. Patients were recommended a prophylactic feeding tube and followed up by a dietician for at least 8 weeks postradiotherapy (post-RT). Potential prognostic factors were analyzed for risk and duration of feeding tube use for at least 25% of dietary requirements.

Results: Many variables had significant effects on risk and/or duration of feeding tube use in univariate analyses. Subsequent multivariable analysis showed that T classification ≥3 and level 2 lymphadenopathy were the best independent significant predictors of higher risk and duration of feeding tube use, respectively, in oral cavity, pharyngeal, and supraglottic primaries.

Conclusion: In patients treated with definitive IMRT, T classification ≥3 and level 2 lymphadenopathy can potentially stratify patients into 4 risk groups for developing severe dysphagia requiring feeding tube use.

Original language	English
Pages (from-to)	2181-2192
Number of pages	12
Journal	Head and Neck
Volume	40
Issue number	10
DOIs	https://doi.org/10.1002/hed.25316
Publication status	Published - Oct 2018

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Pretreatment risk stratification of feeding tube use in patients treated with intensity-modulated radiotherapy for head and neck cancerAccepted author manuscript, 448 KBLicence: Other

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title = "Pretreatment risk stratification of feeding tube use in patients treated with intensity-modulated radiotherapy for head and neck cancer",

abstract = "Background: The purpose of this study was to establish a risk stratification model for feeding tube use in patients who undergo intensity-modulated radiotherapy (IMRT) for head and neck cancers. Methods: One hundred thirty-nine patients treated with definitive IMRT (+/- concurrent chemotherapy) for head and neck mucosal cancers were included in this study. Patients were recommended a prophylactic feeding tube and followed up by a dietician for at least 8 weeks postradiotherapy (post-RT). Potential prognostic factors were analyzed for risk and duration of feeding tube use for at least 25% of dietary requirements. Results: Many variables had significant effects on risk and/or duration of feeding tube use in univariate analyses. Subsequent multivariable analysis showed that T classification ≥3 and level 2 lymphadenopathy were the best independent significant predictors of higher risk and duration of feeding tube use, respectively, in oral cavity, pharyngeal, and supraglottic primaries. Conclusion: In patients treated with definitive IMRT, T classification ≥3 and level 2 lymphadenopathy can potentially stratify patients into 4 risk groups for developing severe dysphagia requiring feeding tube use.",

author = "Anderson, {Nigel J.} and Jackson, {James E.} and Smith, {Jennifer G.} and Morikatsu Wada and Michal Schneider and Michael Poulsen and Maureen Rolfo and Maziar Fahandej and Hui Gan and Joon, {Daryl Lim} and Vincent Khoo",

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year = "2018",

month = oct,

doi = "10.1002/hed.25316",

language = "English",

volume = "40",

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T1 - Pretreatment risk stratification of feeding tube use in patients treated with intensity-modulated radiotherapy for head and neck cancer

AU - Anderson, Nigel J.

AU - Jackson, James E.

AU - Smith, Jennifer G.

AU - Wada, Morikatsu

AU - Schneider, Michal

AU - Poulsen, Michael

AU - Rolfo, Maureen

AU - Fahandej, Maziar

AU - Gan, Hui

AU - Joon, Daryl Lim

AU - Khoo, Vincent

PY - 2018/10

Y1 - 2018/10

N2 - Background: The purpose of this study was to establish a risk stratification model for feeding tube use in patients who undergo intensity-modulated radiotherapy (IMRT) for head and neck cancers. Methods: One hundred thirty-nine patients treated with definitive IMRT (+/- concurrent chemotherapy) for head and neck mucosal cancers were included in this study. Patients were recommended a prophylactic feeding tube and followed up by a dietician for at least 8 weeks postradiotherapy (post-RT). Potential prognostic factors were analyzed for risk and duration of feeding tube use for at least 25% of dietary requirements. Results: Many variables had significant effects on risk and/or duration of feeding tube use in univariate analyses. Subsequent multivariable analysis showed that T classification ≥3 and level 2 lymphadenopathy were the best independent significant predictors of higher risk and duration of feeding tube use, respectively, in oral cavity, pharyngeal, and supraglottic primaries. Conclusion: In patients treated with definitive IMRT, T classification ≥3 and level 2 lymphadenopathy can potentially stratify patients into 4 risk groups for developing severe dysphagia requiring feeding tube use.

AB - Background: The purpose of this study was to establish a risk stratification model for feeding tube use in patients who undergo intensity-modulated radiotherapy (IMRT) for head and neck cancers. Methods: One hundred thirty-nine patients treated with definitive IMRT (+/- concurrent chemotherapy) for head and neck mucosal cancers were included in this study. Patients were recommended a prophylactic feeding tube and followed up by a dietician for at least 8 weeks postradiotherapy (post-RT). Potential prognostic factors were analyzed for risk and duration of feeding tube use for at least 25% of dietary requirements. Results: Many variables had significant effects on risk and/or duration of feeding tube use in univariate analyses. Subsequent multivariable analysis showed that T classification ≥3 and level 2 lymphadenopathy were the best independent significant predictors of higher risk and duration of feeding tube use, respectively, in oral cavity, pharyngeal, and supraglottic primaries. Conclusion: In patients treated with definitive IMRT, T classification ≥3 and level 2 lymphadenopathy can potentially stratify patients into 4 risk groups for developing severe dysphagia requiring feeding tube use.

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U2 - 10.1002/hed.25316

DO - 10.1002/hed.25316

M3 - Article

C2 - 29756389

AN - SCOPUS:85055158381

SN - 1043-3074

VL - 40

SP - 2181

EP - 2192

JO - Head and Neck

JF - Head and Neck

IS - 10

ER -

Pretreatment risk stratification of feeding tube use in patients treated with intensity-modulated radiotherapy for head and neck cancer

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