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Pretreatment risk stratification of feeding tube use in patients treated with intensity‐modulated radiotherapy for head and neck cancer
Author(s) -
Anderson Nigel J.,
Jackson James E.,
Smith Jennifer G.,
Wada Morikatsu,
Schneider Michal,
Poulsen Michael,
Rolfo Maureen,
Fahandej Maziar,
Gan Hui,
Joon Daryl Lim,
Khoo Vincent
Publication year - 2018
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25316
Subject(s) - medicine , feeding tube , dysphagia , head and neck cancer , radiation therapy , univariate analysis , head and neck , swallowing , risk stratification , surgery , multivariate analysis
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.