Development and external validation of a prediction model for tube feeding dependency for at least four weeks during chemoradiotherapy for head and neck cancer

Willemsen, Anna C.H.; Kok, Annemieke; Baijens, Laura W. J.; Boer, Jan Paul de; Bree, Remco de; Devriese, Lot A.; Driessen, Chantal; Herpen, Carla M.L. van; Hoebers, Frank; Kaanders, Johannes H.A.M.; Karsten, Rebecca T.; Kuijk, Sander M J van; Lalisang, Roy I.; Navran, Arash; Pereboom, Susanne R.; Schols, A.M.W.J.; Terhaard, Chris H.J.; Hoeben, Ann

doi:10.1016/j.clnu.2021.11.019

Cited by 9 publications

(5 citation statements)

References 51 publications

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“…Nasoenteric nutrition is indispensable for patients with malignant digestive system tumors or who have undergone digestive tract reconstruction (9-11). Insertion of a nasoenteric feeding tube can not only maintain safe and efficient enteral nutrition (12,13), but can be also used for targeted gastrointestinal decompression, accurate fistula drainage, local radiotherapy of the digestive tract, etc. (14,15).…”

Section: Discussionmentioning

confidence: 99%

“…In the case of simple luminal stenosis, it is necessary to carefully examine the preoperative radiography findings to identify the particularity of the postoperative anatomy and the specific location of gastrointestinal stenoses, adjust the angle of the C-arm projection and the patient's position during the procedure to achieve the ideal view for observing luminal stenosis. In the case of only the guide wire being able to pass through the excessively narrow lumen but not the nasoenteric tube, balloon dilation can widen the segment (12). For critically ill patients who cannot tolerate the balloon operation, the angiographic catheter can temporarily replace the feeding tube for short-term enteral nutrition, until the patient is fit enough to undergo nasoenteric tube placement.…”

Section: Management Of Stenosis Of the Small Bowel Lumenmentioning

confidence: 99%

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Analysis of the causes of failed placement of nasoenteric tube under DSA guidance and treatment strategies for successful re-catheterization

Yang¹,

Shi²,

Shen³

et al. 2022

Ann Palliat Med

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Background: For patients with advanced cancer or patients who have undergone digestive tract reconstruction, enteral nutrition is the most important nutritional support therapy, which can reduce the risk of enteral infection and improve self-immunity; while digital subtraction angiography (DSA) guided nasoenteric tube placement is suitable for nutritional support and palliative treatment of most patients with advanced cancer, many doctors because the preoperative preparation is not sufficient or the intraoperative operation is not standardized, resulting in catheter failure can not achieve the purpose of nutritional supply, and we need to summarize the lessons of failure and optimize the catheterization strategy.Methods: From February 2015 to July 2020, A total of 3,810 cases were treated with DSA guided nasoenteric feeding tube placement. According to the requirements that enteral nutrition could not be performed by the initial catheterization, 94 cases of catheterization failure were selected as the study subjects.The causes of catheterization failure were analyzed and summarized by analyzing the intraoperative image data and operation process; 42 cases of catheterization failure experienced successful catheterization after re-catheterization. By studying the relevant preoperative preparation and intraoperative operation, the treatment strategies and operation methods for successful re-catheterization were summarized.Results: In 94 patients with primary catheterization failure, anastomotic stenosis or obstruction accounted for 20.2%, excessive dilatation of gastric lumen accounted for 17.0%, pyloric stenosis or obstruction of antrum accounted for 13.8%, efferent loop stenosis or obstruction accounted for 11.7%, and the above factors were the main causes of DSA guided feeding tube failure; of the 42 patients with successful recatheterization, 9 patients underwent adequate negative pressure drainage before surgery, 7 patients modified the projection angle by adjusting the C-arm, 5 patients applied cone-beam CT technique, 5 patients used balloon dilatation of the stenotic segment, and the above factors were the main strategy methods for successful recatheterization. Conclusions:The success rate of DSA guided nasoenteric feeding tube placement will be greatly improved by adequate gastrointestinal decompression and drainage and other related preoperative preparation as well as good intraoperative application of cone-beam CT technique or combined application of balloon, gastroscope, stent and other technical means.

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Section: Discussionmentioning

confidence: 99%

Section: Management Of Stenosis Of the Small Bowel Lumenmentioning

confidence: 99%

Analysis of the causes of failed placement of nasoenteric tube under DSA guidance and treatment strategies for successful re-catheterization

Yang¹,

Shi²,

Shen³

et al. 2022

Ann Palliat Med

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“…For acute OM, eight models were identified with AUCs ranging from 0.65 to 0.81 [16][17][18][19][20][21][22][23]. Five models emerged for acute dysphagia (AUC: 0.60-0.82) [93][94][95][96][97], and nine for late dysphagia (AUC: 0.70-0.85) [98][99][100][101][102][103][104][105][106]. A considerable variability in model performance was evident, suggesting opportunities for further improvement.…”

Section: Performance Of Predictive Modelsmentioning

confidence: 99%

“…Among the validated predictive models for dysphagia, five predicted acute dysphagia and nine predicted late dysphagia. For acute dysphagia, outcomes were defined as tube feeding dependence [94][95][96] or CTCAE grading severe or higher (≥grade 3) [93,97]. The validation performance, as measured by the AUC, ranged from 0.60 to 0.82.…”

Section: Predictive Models For Oral Mucositis and Dysphagiamentioning

confidence: 99%

“…The grading system used for assessing toxicity can vary, as can the criteria for interventions such as tube feeding, a common outcome measure for dysphagia. For example, Dean et al observed a difference in the scoring system for dysphagia between their training data and their validation data [97], and Willemsen et al, noted that individual and institutional preferences in feeding tube insertion policy may affect the apparent incidence of dysphagia [94]. Furthermore, the treatment regimen can also vary between centers.…”

Section: Limitations Of Predictive Modelsmentioning

confidence: 99%

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Predictive Factors for Chemoradiation-Induced Oral Mucositis and Dysphagia in Head and Neck Cancer: A Scoping Review

Nicol,

Ching,

Tam

et al. 2023

Cancers

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Despite advances in head and neck cancer treatment, virtually all patients experience chemoradiation-induced toxicities. Oral mucositis (OM) and dysphagia are among the most prevalent and have a systemic impact on patients, hampering treatment outcome and harming quality of life. Accurate prediction of severe cases is crucial for improving management strategies and, ultimately, patient outcomes. This scoping review comprehensively maps the reported predictors and critically evaluates the performance, methodology, and reporting of predictive models for these conditions. A total of 174 studies were identified from database searches, with 73 reporting OM predictors, 97 reporting dysphagia predictors, and 4 reporting both OM and dysphagia predictors. These predictors included patient demographics, tumor classification, chemoradiotherapy regimen, radiation dose to organs-at-risk, genetic factors, and results of clinical laboratory tests. Notably, many studies only conducted univariate analysis or focused exclusively on certain predictor types. Among the included studies, numerous predictive models were reported: eight for acute OM, five for acute dysphagia, and nine for late dysphagia. The area under the receiver operating characteristic curve (AUC) ranged between 0.65 and 0.81, 0.60 and 0.82, and 0.70 and 0.85 for acute oral mucositis, acute dysphagia, and late dysphagia predictive models, respectively. Several areas for improvement were identified, including the need for external validation with sufficiently large sample sizes, further standardization of predictor and outcome definitions, and more comprehensive reporting to facilitate reproducibility.

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EBD in de praktijk: diëtistisch zorgproces

Runia,

Visser,

Witteman

et al. 2024

Evidence-Based Diëtetiek

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Development and external validation of a prediction model for tube feeding dependency for at least four weeks during chemoradiotherapy for head and neck cancer

Cited by 9 publications

References 51 publications

Analysis of the causes of failed placement of nasoenteric tube under DSA guidance and treatment strategies for successful re-catheterization

Analysis of the causes of failed placement of nasoenteric tube under DSA guidance and treatment strategies for successful re-catheterization

Predictive Factors for Chemoradiation-Induced Oral Mucositis and Dysphagia in Head and Neck Cancer: A Scoping Review

EBD in de praktijk: diëtistisch zorgproces

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