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Title: Pretreatment risk stratification of feeding tube use in patients treated with intensity-modulated radiotherapy for head and neck cancer.
Austin Authors: Anderson, Nigel J;Jackson, James E;Smith, Jennifer G;Wada, Morikatsu ;Schneider, Michal;Poulsen, Michael;Rolfo, Maureen;Fahandej, Maziar;Gan, Hui K ;Joon, Daryl Lim;Khoo, Vincent
Affiliation: Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
School of Medicine, Griffith University, Gold Coast, Australia
Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
Plain Statistics Pty Ltd, Horsham, Victoria, Australia
Department of Medical Imaging and Radiation Sciences, Monash University, Victoria, Australia
Radiation Oncology Centres, Gold Coast University Hospital, Queensland, Australia
Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
Department of Palliative Care, St Vincent's Hospital, Fitzroy, Victoria, Australia
Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
Department of Clinical Oncology, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Chelsea, London, UK
Department of Medicine, University of Melbourne, Victoria, Australia
Issue Date: 13-May-2018 2018-10
Publication information: Head & neck 2018; 40(10): 2181-2192
Abstract: 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. 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. 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. 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.
DOI: 10.1002/hed.25316
ORCID: 0000-0002-4826-2339
PubMed URL: 29756389
Type: Journal Article
Subjects: enteral nutrition
feeding tube
head and neck cancer
intensity-modulated radiotherapy (IMRT)
Appears in Collections:Journal articles

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