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Factors associated with gastrostomy tube dependence after concurrent chemoradiotherapy for hypopharyngeal cancer

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Abstract

Purpose

We aimed to identify tumor- and treatment-related factors predicting gastrostomy tube dependence after concurrent chemoradiotherapy (CCRT) for hypopharyngeal cancer.

Methods

We performed a retrospective review of all patients with hypopharyngeal cancer treated with CCRT between 2002 and 2012 except for those with residual or recurrent disease at evaluation. The incidence of gastrostomy tube dependence, defined as complete or almost complete dependence on tube feeding, at 6 months after the completion of treatment was the endpoint. A total of 75 patients were analyzed in this study.

Results

Twelve patients (16 %) showed gastrostomy tube dependence. Among tumor-related factors, the subsite (posterior wall versus pyriform sinus plus postcricoid) was the most significant factor correlated with gastrostomy tube dependence (p < 0.01 by multivariate analysis). The T category of the primary tumor was also correlated with gastrostomy tube dependence on univariate analysis (p < 0.01). Among treatment-related factors, the radiation dose was not associated with gastrostomy tube dependence. On the other hand, gastrostomy tube dependence was also correlated with the requirement of supportive nutrition with a nasogastric tube at the beginning of and during treatment (both p < 0.01).

Conclusion

Risk factors for gastrostomy tube dependence after the completion of CCRT for hypopharyngeal cancer were identified.

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References

  1. Pignon JP, Bourhis J, Domenge C, Designe L (2000) Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. Lancet 355:949–955

    Article  CAS  PubMed  Google Scholar 

  2. Pignon JP, le Maitre A, Maillard E, Bourhis J (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92:4–14

  3. Robbins KT (2002) Barriers to winning the battle with head-and-neck cancer. Int J Radiat Oncol Biol Phys 53:4–5

  4. Samant S, Kumar P, Wan J, Hanchett C, Vieira F, Murry T et al (1999) Concomitant radiation therapy and targeted cisplatin chemotherapy for the treatment of advanced pyriform sinus carcinoma: disease control and preservation of organ function. Head Neck 7:595–601

  5. Bhayani MK, Hutcheson KA, Barringer DA, Roberts DB, Lewin JS, Lai SY (2013) Gastrostomy tube placement in patients with hypopharyngeal cancer treated with radiotherapy or chemoradiotherapy: factors affecting placement and dependence. Head Neck 35:1641–1646

    Article  PubMed  Google Scholar 

  6. Henk JM (1997) Controlled trials of synchronous chemotherapy with radiotherapy in head and neck cancer: overview of radiation morbidity. Clin Oncol (R Coll Radiol) 9:308–312

  7. Machtay M, Moughan J, Trotti A, Garden AS, Weber RS, Cooper JS et al (2008) Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol 26:3582–3589

    Article  CAS  PubMed  Google Scholar 

  8. Bradley PT, Bradley PJ (2012) Treatment of hypopharyngeal carcinoma with primary chemoradiotherapy: functional morbidity. Curr Opin Otolaryngol Head Neck Surg 20:89–96

    Article  PubMed  Google Scholar 

  9. Lee WT, Akst LM, Adelstein DJ, Saxton JP, Wood BG, Strome M et al (2006) Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation. Head Neck 28:808–812

    Article  PubMed  Google Scholar 

  10. Agarwal J, Palwe V, Dutta D, Gupta T, Laskar SG, Budrukkar A et al (2011) Objective assessment of swallowing function after definitive concurrent (chemo)radiotherapy in patients with head and neck cancer. Dysphagia 26:399–406

  11. Mekhail TM, Adelstein DJ, Rybicki LA, Larto MA, Saxton JP, Lavertu P (2001) Enteral nutrition during the treatment of head and neck carcinoma: is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube? Cancer 91:1785–1790

    Article  CAS  PubMed  Google Scholar 

  12. Machtay M, Moughan M, Farach A, Martin-O’Meara E, Galvin J, Garden AS et al (2012) Hypopharyngeal dose is associated with severe late toxicity in locally advanced head-and-neck cancer: an RTOG analysis. Int J Radiat Oncol Biol Phys 84:983–989

    Article  PubMed Central  PubMed  Google Scholar 

  13. Ames JA, Karnell LH, Gupta AK, Coleman TC, Karnell MP, Van Daele DJ et al (2011) Outcomes after the use of gastrostomy tubes in patients whose head and neck cancer was managed with radiation therapy. Head Neck 33:638–644

    Article  PubMed  Google Scholar 

  14. Paximadis P, Yoo G, Lin HS, Jacobs J, Sukari A, Dyson G et al (2012) Concurrent chemoradiotherapy improves survival in patients with hypopharyngeal cancer. Int J Radiat Oncol Biol Phys 82:1515–1521

  15. Nomura K, Takahara M, Katayama A, Kishibe K, Kunibe I, Katada A et al (2013) Intra-arterial cisplatin with concomitant radiation for advanced hypopharyngeal cancer. Laryngoscope 123:916–922

    Article  CAS  PubMed  Google Scholar 

  16. Platteaux N, Dirix P, Dejaeger E, Nuyts S (2010) Dysphagia in head and neck cancer patients treated with chemoradiotherapy. Dysphagia 25:139–152

    Article  PubMed  Google Scholar 

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Correspondence to Shigeyuki Murono.

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Murono, S., Tsuji, A., Endo, K. et al. Factors associated with gastrostomy tube dependence after concurrent chemoradiotherapy for hypopharyngeal cancer. Support Care Cancer 23, 457–462 (2015). https://doi.org/10.1007/s00520-014-2388-8

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  • DOI: https://doi.org/10.1007/s00520-014-2388-8

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