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Reduced feeding tube duration with intensity‐modulated radiation therapy for head and neck cancer: A Surveillance, Epidemiology, and End Results‐Medicare Analysis
Author(s) -
Beadle Beth M.,
Liao KaiPing,
Giordano Sharon H.,
Garden Adam S.,
Hutcheson Katherine A.,
Lai Stephen Y.,
Guadagnolo B. Ashleigh
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30350
Subject(s) - medicine , feeding tube , radiation therapy , head and neck cancer , cohort , head and neck , surveillance, epidemiology, and end results , surgery , epidemiology , nuclear medicine , cancer registry
BACKGROUND Intensity‐modulated radiation therapy (IMRT) is a technologically advanced and resource‐intensive method of delivering radiation therapy (RT) and is used to minimize toxicity for patients with head and neck cancer (HNC). Dependence on feeding tubes is a significant marker of toxicity of RT. The objective of this analysis was to compare the placement and duration of feeding tube use among patients with HNC from 1999 through 2011. METHODS The cohort, demographics, and cancer‐related variables were determined using the linked Surveillance, Epidemiology, and End Results (SEER)‐Medicare database, and claims data were used to analyze treatment details. RESULTS In total, 2993 patients were identified. At a median follow‐up of 47 months, 54.4% of patients had ever had a feeding tube placed. The median duration from feeding tube placement to removal was 277 days. On zero‐inflated negative binomial regression, patients who received IMRT and 3‐dimensional RT (3DRT) (non‐IMRT) had similar rates of feeding tube placement (odds ratio, 1.10; P = .35); however, patients who received 3DRT had a feeding tube in place 1.18 times longer than those who received IMRT ( P = .03). The difference was only observed among patients who received definitive RT; patients who underwent surgery and also received adjuvant RT had no statistically significant difference in feeding tube placement or duration. CONCLUSIONS Patients with HNC who received definitive IMRT had a significantly shorter duration of feeding tube placement than those who received 3DRT. These data suggest that there may be significant quality‐of‐life benefits to IMRT with respect to long‐term swallowing function in patients with HNC. Cancer 2017;123:283–293. © 2016 American Cancer Society .