Investigation of p16 status, chemotherapy regimen, and other nutrition markers for predicting gastrostomy in patients with head and neck cancer

Abstract

Malnutrition risk and p16 status could be used to identify further patients who may benefit from proactive gastrostomy. © 2017 Wiley Periodicals, Inc. Head Neck 39: 868-875, 2017.

Prediction model for tube feeding dependency during chemoradiotherapy for at least four weeks in head and neck cancer patients: A tool for prophylactic gastrostomy decision making

“…Potential predictors were preselected based on clinical reasoning and evidence of previous research. We preselected patient's age [34e38], gender [29,37], tobacco [39], and alcohol use, body mass index (BMI) [40,41], weight loss [42,43], and texture modified diet at baseline (as indicator for dysphagia) [29,37,42], in which baseline is considered right before treatment initiation, World Health Organization performance status (WHO PS) [44e46], tumor subsite [35,37,41,47,48], tumor stage [35e37, 40,42,43,47e51], nodal stage [24,36,37,39,41] (TNM-classification [52]), human papilloma virus (HPV) in situ hybridization (ISH) or P16 expression (surrogate biomarker of HPV infection) of the tumor [34], primary or adjuvant setting [41,44,47], type of radiosensitizing systemic therapy (platinum-based chemotherapy or immunotherapy) [35,39,42e44,47], bilateral neck irradiation [24,49,53], mean RT dose on the contralateral submandibular [44] and parotid gland [43,44].…”

Home-based telehealth service for swallowing and nutrition management following head and neck cancer treatment

“…Swallowing and communication difficulties and associated nutritional issues are common side-effects of (chemo)radiotherapy (C/RT) for head and neck cancer (HNC). 1-8 Regular speech pathology (SP) and nutrition and dietetics (ND) post-treatment reviews are recommended as best practice 9-11 to monitor symptom recovery and optimize rehabilitation. However many patients experience difficulties attending these appointments due to acute illness, transport difficulties, travel costs and work commitments.…”

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

“…The potential predictors of TF dependency were based on existing literature and included: age [30], gender [31,32], tobacco use [33], alcohol use, Body Mass Index (BMI) at baseline [34,35], pretreatment weight change [36], texture modified diet at baseline (e.g. ground, minced or liquid) [31], Eastern Cooperative Oncology Group performance status (ECOG PS) [37], tumor site [31,35], T classification [9,31], N classification [31,35] (AJCC 7th edition TNM staging system [38]), disease stage, p16 status [39] (immunohistochemically as a surrogate marker for human papillomavirus (HPV), treatment setting (primary or adjuvant) [35], type of systemic therapy (platinum based or cetuximab) [33] and neck irradiation (non or unilateral versus bilateral) [9]. The dosimetric parameters extracted from electronic health records were: mean RT dose (in Gy) to the contralateral submandibular and parotid gland, swallowing muscles (PCM), and oral cavity (OC).…”