Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program

Bozec, A.; Bénézery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, O.; Poissonnet, G.; Riss, J. M.; Hannoun‐Lévi, Jean‐Michel; Chand, Marie-Eve; Leysalle, A.; Saâda, Esma; Sudaka, Anne; Haudebourg, Juliette; Hébert, Christophe; Falewee, M. N.; Démard, F; Santini, J.; Peyrade, Fréd́eric

doi:10.1007/s00405-015-3785-4

Cited by 12 publications

(26 citation statements)

References 14 publications

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“…Eventually, a total of 14 clinical studies with prognostic factors for tube feeding dependence at !6 months remained for review (Fig. 1) [46,[94][95][96][97][98][99][100][101][102][103][104][105][106]. Three studies reporting on prognostic factors for tube feeding dependence at !6 months, also reported on prognostic factors for feeding tube placement or feeding tube use at <6 months; these factors are reported in Supplement 2 [94,95,103].…”

Section: Resultsmentioning

confidence: 99%

“…1) [46,[94][95][96][97][98][99][100][101][102][103][104][105][106]. Three studies reporting on prognostic factors for tube feeding dependence at !6 months, also reported on prognostic factors for feeding tube placement or feeding tube use at <6 months; these factors are reported in Supplement 2 [94,95,103]. The included studies by Bozec et al were both published in 2016 and performed with the same cohort, but they had slightly different endpoints and considered different variables in the multivariate analysis for prognostic factors.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic factors for tube feeding dependence after curative (chemo-) radiation in head and neck cancer: A systematic review of literature

Wopken

Bijl

Langendijk

2018

Radiotherapy and Oncology

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prognostic factors for tube feeding dependence after curative (chemo-) radiation in head and neck cancer: A systematic review of literature

Wopken

Bijl

Langendijk

2018

Radiotherapy and Oncology

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“…Last, noncancer and treatment-related deaths were higher in the concomitant arm. 9 Although there is no consensus in the literature 8,[12][13][14][15][16][17][18][19] about the optimal definition of OFPF, the definition used in the current study covers, in our opinion, all the relevant issues involved in functional outcomes of these patients. Furthermore, the data on predictive factors for OFPF are scarce and frequently conflicting.…”

Section: Discussionmentioning

confidence: 99%

Organ Function Preservation Failure after (Chemo)Radiotherapy in Head and Neck Cancer: A Retrospective Cohort Analysis

Heukelom

Navran

Gouw

et al. 2019

Otolaryngol.--head neck surg.

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Objective The aim of the current study was to determine the incidence of organ function preservation failure (OFPF) in patients with head and neck squamous cell carcinoma (HNSCC) treated by (chemo)radiotherapy and to identify its risk factors. Study Design Retrospective cohort analysis. Setting Tertiary cancer care center. Subjects and Methods A single-center retrospective cohort analysis was done (n = 703) in which OFPF after (chemo)radiotherapy was assessed. OFPF was defined as local failure or pure functional failure in the absence of local failure because of major surgical intervention (total laryngectomy, commando resection, permanent tracheostomy) or feeding tube dependence >2 years. Results OFPF occurred in 153 patients (21.8%). Reasons for OFPF were local failure in 103 patients (14.6%) and functional failure in 50 patients (7.2%). Evidence of functional failure included need for total laryngectomy (n = 9, 1.3%), commando resection (n = 2, 0.3%), permanent tracheostomy (n = 16, 2.3%), and/or long-term feeding tube for functional reasons (n = 23, 3.3%). In a Cox proportional hazards model, OFPF was worse for patients with T4 tumors (hazard ratio [HR] <0.5 and P < .001 for all other stages), for laryngeal vs oropharyngeal cancer (HR, 1.83; 95% confidence interval [CI], 1.20-2.79, P = .005, hypopharyngeal not significant), and for smokers (HR, 1.68; 95% CI, 1.10-2.56, P = .015). Exploratory multivariate analysis by tumor site showed that T4 tumor and pretreatment tracheostomy were the strongest predictive factors for OFPF in laryngeal and hypopharyngeal carcinoma while T4 tumor and smoking were predictive for poor OFPF in oropharyngeal carcinoma. Conclusion This work shows a detrimental effect of smoking on functional outcomes after (chemo-)radiotherapy for HNSCC. Moreover, T4 tumor, laryngeal subsite, and pretreatment tracheostomy are strong predictors of OFPF.

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“…Multiple previous studies [12,20,21] have identified predictors for acute enteral feeding dependency but a recent systematic review showed these to be based predominantly on patient cohorts with prophylactic feeding tubes sited. Only one publication basing analysis on patients managed with an exclusively reactive approach was identified e a small cohort of hypopharynx patients with no dosimetric information reported [12,22]. Ours is the first study to assess clinical and dosimetric predictive factors in a large cohort of patients following an exclusively reactive feeding strategy.…”

Section: Discussionmentioning

confidence: 99%

A Predictive Model for Reactive Tube Feeding in Head and Neck Cancer Patients Undergoing Definitive (Chemo) Radiotherapy

et al. 2021

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Aims: Careful management of a patient's nutritional status during and after treatment for head and neck squamous cell cancers (HNSCC) is crucial for optimal outcomes. The aim of this study was to develop a model for stratifying a patient's risk of requiring reactive enteral feeding through a nasogastric tube during radiotherapy for HNSCC, based on clinical and treatment-related factors. Materials and methods: A cohort of consecutive patients treated with definitive (chemo)radiotherapy for HNSCC between January 2016 and January 2018 was identified in the institutional electronic database for retrospective analysis. Patients requiring enteral feeding pretreatment were excluded. Clinical and treatment data were obtained from prospectively recorded electronic clinical notes and planning software. Results: Baseline patient characteristics and tumour-related parameters were captured for 225 patients. Based on the results of the univariate analysis and using a stepwise backwards selection process, clinical and dosimetric variables were selected to optimise a clinically predictive multivariate model, fitted using logistic regression. The parameters found to affect the probability, P, of requiring a nasogastric feeding tube for >4 weeks in our clinical multivariate model were: tumour site, tumour stage (early T0/1/2 stage versus advanced T3/T4 stage), chemotherapy drug (none versus any drug) and mean dose to the contralateral parotid gland. A scoring model using the regression coefficients of the selected variables in the clinical multivariate model achieved an area under the curve (AUC) of 0.745 (95% confidence interval 0.678e0.812), indicating good discriminative performance. Internal validation of the model involved splitting the dataset 80:20 into training and test datasets 10 times and assessing differences in AUC of the model fitted to these. Conclusions: We developed an easy-to-use prediction model based on both clinical and dosimetric parameters, which, once externally validated, can lead to more personalised treatment planning and inform clinical decision-making on the appropriateness of prophylactic versus reactive enteral feeding.

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Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program

Cited by 12 publications

References 14 publications

Prognostic factors for tube feeding dependence after curative (chemo-) radiation in head and neck cancer: A systematic review of literature

Prognostic factors for tube feeding dependence after curative (chemo-) radiation in head and neck cancer: A systematic review of literature

Organ Function Preservation Failure after (Chemo)Radiotherapy in Head and Neck Cancer: A Retrospective Cohort Analysis

A Predictive Model for Reactive Tube Feeding in Head and Neck Cancer Patients Undergoing Definitive (Chemo) Radiotherapy

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