Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/22792
Title: Clinical and dosimetric risk stratification for patients at high-risk of feeding tube use during definitive IMRT for head and neck cancer.
Authors: Jackson, James E;Anderson, Nigel J;Wada, Morikatsu;Schneider, Michal;Poulsen, Michael;Rolfo, Maureen;Fahandej, Maziar;Gan, Hui;Joon, Daryl Lim;Khoo, Vincent
Affiliation: Department of Medicine, University of Melbourne, Victoria, Australia
Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
Department of Clinical Oncology, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Chelsea, London, UK
Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Icon Cancer Centres, Gold Coast University Hospital, Queensland, Australia
Department of Palliative Care, St Vincent's Hospital, Fitzroy, Victoria, Australia
Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Sciences, Monash University, Victoria, Australia
Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
School of Medicine, Griffith University, Gold Coast, Australia
Department of Radiation Oncology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Jun-2020
EDate: 2020-02-28
Citation: Technical innovations & patient support in radiation oncology 2020; 14: 1-10
Abstract: To identify organs to which dose limitation using intensity modulated radiotherapy (IMRT) can potentially modify the incidence and duration of feeding tube use, during and immediately following therapy for head and neck cancer. One hundred and fourteen patients treated with definitive IMRT (± concurrent chemotherapy) head and neck mucosal cancers were included. Patients received a prophylactic feeding tube and followed up by a dietician for at least eight weeks post-radiotherapy. Salivary and swallowing organs were delineated for each patient. Tumour and dosimetric variables were recorded for all patients and analysed for incidence and duration of feeding tube use for at least 25% of dietary requirements. Multivariate analysis showed T-classification ≥3 and level II lymphadenopathy as independent significant predictors of incidence and duration of feeding tube use in oral cavity, pharyngeal and supraglottic primaries. Mean dose deposited in the cervical oesophagus over 36Gy further increased the incidence and duration of feeding tube use. Mean dose deposited in the base of tongue and superior pharyngeal constrictor muscles affected incidence and duration of feeding tube use, respectively. In patients treated with definitive IMRT, T-classification and Level II lymphadenopathy, combined with a mean cervical oesophagus dose over 36Gy can a stratify patients into eight distinct risk groups for using feeding tubes for at least 25% of their dietary requirements.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22792
DOI: 10.1016/j.tipsro.2020.01.003
ORCID: 0000-0002-1947-9694
0000-0002-4826-2339
PubMed URL: 32154393
Type: Journal Article
Subjects: Enteral nutrition
Head and neck neoplasms
Intensity-modulated
Radiation dosage
Radiotherapy
Appears in Collections:Journal articles

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