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

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6 Citations (Scopus)

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 languageEnglish
Pages (from-to)2181-2192
Number of pages12
JournalHead & Neck
Volume40
Issue number10
DOIs
Publication statusPublished - 1 Oct 2018

Keywords

  • enteral nutrition
  • feeding tube
  • head and neck cancer
  • intensity-modulated radiotherapy (IMRT)
  • toxicity

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