Validation of the total dysphagia risk score (TDRS) in head and neck cancer patients in a conventional and a partially accelerated radiotherapy scheme

Nevens, Daan; Deschuymer, Sarah; Langendijk, Johannes A.; Daisne, Jean-François; Duprez, Frédéric; Neve, Wilfried De; Nuyts, Sandra

doi:10.1016/j.radonc.2015.10.008

Cited by 4 publications

(9 citation statements)

References 15 publications

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“…The median neck SMI was 12 (range [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], and 61 patients (48%) became prolonged feeding tube-dependent (see Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…16 First, the extent of tumor and treatment disrupt normal swallowing physiology, and with more extensive tumor and treatment, the risk for developing swallowing problems is increased. [17][18][19][20][21][22][23][24] Second, poor nutritional status can also contribute to swallowing dysfunction, due to loss of muscle mass and function. [19][20][21][22][23][24] As a result of swallowing dysfunction, a substantial proportion (50%-70%) of patients become feeding tube-dependent during CRT.…”

Section: Introductionmentioning

confidence: 99%

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Sarcopenia, a strong determinant for prolonged feeding tube dependency after chemoradiotherapy for head and neck cancer

et al. 2019

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Background Sarcopenia might be a relevant lead for optimization of the condition of patients with head and neck cancer (HNC) before chemoradiotherapy (CRT) to prevent long‐term functional swallowing impairment, such as feeding tube dependency. Methods Regression analyses were performed to assess the association between skeletal muscle mass index (SMI), as a measure of sarcopenia, and prolonged (>90 days) feeding tube dependency in 128 patients with HNC treated with primary CRT. Results Sixty‐one patients (48%) became prolonged feeding tube‐dependent. Lower SMI increased the risk of prolonged feeding tube dependency in multivariable analysis (risk ratio 1.08; 95% confidence interval 1.02‐1.14, P = .01) adjusted for body mass index, abnormal diet, and socioeconomic status. Conclusions Sarcopenia contributes to the risk of prolonged feeding tube dependency of patients with HNC treated with primary CRT. As sarcopenia might be a modifiable factor prior to treatment, it should be explored as a target for pretreatment patients' condition.

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“…The median neck SMI was 12 (range [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], and 61 patients (48%) became prolonged feeding tube-dependent (see Table 1).…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sarcopenia, a strong determinant for prolonged feeding tube dependency after chemoradiotherapy for head and neck cancer

et al. 2019

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“…3 This risk model was validated retrospectively 7 and in a prospective manner. 8 The purpose of this study was to correlate TDRS with videofluoroscopy evaluation. This is the first paper to correlate this model with videofluoroscopies.…”

Section: Discussionmentioning

confidence: 99%

“…We defined the weight loss as the percentage of total body weight lost during the 6 months prior to RT, as we did in a previous paper. 8 The TDRS was scored as described in the original paper. 3 To determine the inter-rater agreement between both observers, the intraclass correlation coefficient (ICC) was calculated.…”

Section: Statisticsmentioning

confidence: 99%

“…This risk model was validated retrospectively by one research group for acute dysphagia 7 and for acute and late dysphagia (1, 3, 6 and 9 months following CRT) by our research group in a prospective manner. 8 The aim of this study was to correlate the TDRS with swallowing function as measured by videofluroscopies [using the swallowing performance scale (SPS) and the penetration aspiration scale (PAS)-scales can be found in the Supplementary Material 1]. The TDRS is known to correlate with physician-scored dysphagia but the relation to objective measurements like videofluoroscopy is unknown.…”

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confidence: 99%

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Does the total dysphagia risk score correlate with swallowing function examined by videofluoroscopy?

Nevens

Goeleven²,

Duprez

et al. 2017

The British Journal of Radiology

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Patients with high-risk TDRS scores have higher SPS scores when compared to the intermediate group and the intermediate- and low-risk group together. However, low-risk patients in our patient cohort could not be distinguished from high or intermediate-risk patients. Advances in knowledge: TDRS was never correlated with videofluoroscopies in past studies. The hypothesis of this paper was to see if the TDRS could guide us to see which patients are at risk for high scores on SPS and PAS and might need a videofluoroscopic examination in the follow up. Given the poor correlations in our study, however, we cannot recommend the use of the TDRS to select patients who might benefit from the additional information provided by videofluoroscopies.

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Correlation of Patient- and Physician-Scored Dysphagia with Videofluoroscopies in Patients Treated with Radiotherapy for Head and Neck Cancer

et al. 2018

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The aim of this study was to investigate the correlation between patient-scored dysphagia and physician-scored dysphagia in head and neck cancer patients treated with radiotherapy. Furthermore, we wanted to compare both patient- and physician-scored dysphagia with dysphagia evaluated on swallowing videofluoroscopies. Sixty-three patients from two different centers treated with radiotherapy for head and neck cancer were evaluated in the current study. Swallowing videofluoroscopies at baseline, 6, and 12 months following radiotherapy were evaluated by 2 observers using the Penetration Aspiration Scale (PAS) and Swallowing Performance Status Scale (SPS) and correlated with patient and physician scored dysphagia. We observed a significant association between physician and patient scored dysphagia (p < 0.01), pre-treatment and post-treatment. Furthermore, the risk of observing dysphagia on videofluoroscopies increased significantly with increasing scores of both physician as well as patient scored dysphagia, and this at all assessed time-points. Patient-scored dysphagia correlates better with dysphagia evaluated by the PAS. Physician-scored dysphagia, however, correlates better with dysphagia as evaluated using the SPS. Both physician- and patient-scored dysphagia correlate well with dysphagia evaluated on videofluoroscopies. Since patient-scored dysphagia correlates better with PAS and changes in the PAS score, and physician-scored dysphagia correlates better with SPS, we advocate to use both patient- and physician-scored dysphagia in future trials.

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Validation of the total dysphagia risk score (TDRS) in head and neck cancer patients in a conventional and a partially accelerated radiotherapy scheme

Abstract: We found significant correlations between TDRS and dysphagia grade ⩾2 and PEG-tube usage.

Cited by 4 publications

References 15 publications

Sarcopenia, a strong determinant for prolonged feeding tube dependency after chemoradiotherapy for head and neck cancer

Sarcopenia, a strong determinant for prolonged feeding tube dependency after chemoradiotherapy for head and neck cancer

Does the total dysphagia risk score correlate with swallowing function examined by videofluoroscopy?

Correlation of Patient- and Physician-Scored Dysphagia with Videofluoroscopies in Patients Treated with Radiotherapy for Head and Neck Cancer

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