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Background  Curative radiotherapy or chemoradiation for head and neck cancer (HNC) may result in severe acute and late side effects, including tube feeding dependence.  The purpose of this prospective cohort study was to develop a prediction model for tube feeding dependence 6 months (TUBE M6 ) after curative (chemo-) radiotherapy in HNC patients.    Patients and Methods  Tube feeding dependence was scored prospectively. To develop the multivariable model, a group LASSO analysis was carried out, with TUBE M6  as the primary endpoint (n = 427). The model was then validated in a test cohort (n = 183). The training cohort was divided into three groups based on the risk of TUBE M6  to test whether the model could be extrapolated to later time points (12, 18 and 24 months).    Results  Most important predictors for TUBE M6  were weight loss prior to treatment, advanced T-stage, positive N-stage, bilateral neck irradiation, accelerated radiotherapy and chemoradiation. Model performance was good, with an Area under the Curve of 0.86 in the training cohort and 0.82 in the test cohort. The TUBE M6 -based risk groups were significantly associated with tube feeding dependence at later time points (p<0.001).    Conclusion  We established an externally validated predictive model for tube feeding dependence after curative radiotherapy or chemoradiation, which can be used to predict TUBE M6 .

Development and Validation of a Prediction Model for Tube Feeding Dependence after Curative (Chemo-) Radiation in Head and Neck Cancer