Purpose/Objective(s): Concurrent chemoradiation for head-and-neck cancer (HNC) may lead to increased rates of long term dysphagia as a severe side effect. Percutaneous endoscopic gastrostomy (PEG) may be indicated in numerous situations in HNC patients undergoing chemoirradiation when normal nutrition becomes impossible. It is still under debate, which predictive factors for prophylactic PEG tube insertion are useful.Materials/Methods: From an institutional database, 101 patients (72 male, 29 female, mean age 59.5 years) with concurrent radiochemotherapy for HNC were included in this study. Clinical factors (ECOG performance status, age, TNM stage), administration of chemotherapy and several organ-at-risk dosimetric parameters (oropharynx + 1cm margin, superficial pharyngeal constrictor muscle, larynx, oral cavity) were correlated with the need for tube feeding or parenteral nutrition for more than 4 days using a multiple logistic regression model.Results: Whereas several dosimetric and clinical factors were significant predictors for the need of artificial nutrition on univariate analysis, on multivariate analysis only three factors remained independently significant: Mean dose to the oropharynx + 1 cm circumferential margin, ECOG performance state and the use of chemotherapy.Conclusions: Using a multiple logistic regression model we could distinguish HNC-patients with different risk factors for the need of additional feeding during radiochemotherapy.
Boelke, E,
Criteria for a Prophylactic Gastrostomy in Head and Neck Cancer Patients Receiving Concurrent Radiochemotherapy. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.
http://archive.rsna.org/2014/14041329.html
