Clinical and dosimetric factors associated with a prolonged feeding tube requirement in patients treated with chemoradiotherapy (CRT) for head and neck cancers.
BACKGROUND
Patients treated with chemoradiotherapy (CRT) for head and neck cancers often require feeding tubes (FTs) due to toxicity. We sought to identify factors associated with a prolonged FT requirement.


METHODS
We retrospectively reviewed 80 patients treated with CRT for head and neck cancers. The pharyngeal constrictors (PCs), supraglottic larynx (SGL), and glottic larynx (GL) were contoured and the mean radiation doses and the volumes of each receiving >40, 50, 60, and 70 Gy (V40, V50, V60, and V70) were determined.


RESULTS
A total of 33 of 80 patients required a FT either before or during the course of CRT. Fifteen patients required the FT for > or = 6 months. On univariate analysis, significant factors associated with a prolonged FT requirement were mean PC dose, PC-V60, PC-V70, SGL dose, SGL-V70, and advanced T3-T4 disease. Multivariate analyses found both PC-V70 and T3-T4 disease as significant factors .The proportions of patients requiring a FT > or = 6 months were 8% and 28% for treatment plans with PC-V70 <30% and > or = 30%, respectively.


CONCLUSIONS
Increased radiation dose to the PCs is associated with a higher risk of a prolonged FT need. Dose sparing of the PC muscles may reduce this risk.
Gokhale
A S
AS
Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
McLaughlin
B T
BT
Flickinger
J C
JC
Beriwal
S
S
Heron
D E
DE
Ferris
R L
RL
Johnson
J
J
Gibson
M K
MK
Argiris
A
A
Smith
R P
RP
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D003131:Combined Modality Therapy; D004750:Enteral Nutrition; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000528:radiation effects; D009367:Neoplasm Staging; D010614:Pharynx / Q000528:radiation effects*; D011832:Radiation Injuries / Q000150:complications*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013995:Time
D000970:Antineoplastic Agents