The "rocky treatment course": identifying a high-risk subgroup of head and neck cancer patients for supportive interventions.
We aim to identify the risk factors for a "rocky" treatment course (RTC) in head and neck cancer.



A retrospective case-control study was conducted utilizing data from a prospective study. We defined the RTC as a composite of adverse outcomes including G-tube dependence and increased nursing interventions. Statistically associative variables were included in a multivariable logistic regression. We also evaluated whether the RTC, or its components, associated with worse cancer outcomes.



Being single, unemployed, having N2/3 disease and receiving chemoradiotherapy were associated with a RTC. In turn, G-tube dependence was associated with worse 3-year OS (73 vs 91 %; p = 0.02) and increased nursing interventions with worse 3-year locoregional recurrence-free survival (LRFS) (85 vs 92 %; p = 0.03) and locoregional recurrence (LRR) (14 vs 7 %; p = 0.03).



We identified baseline factors associated with a RTC for head and neck cancer patients. Future supportive care interventions could be evaluated using the RTC as a marker of benefit.
Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
Horia
0000-0003-3032-0024
H
Vulpe
Department of Psychiatry, Sunnybrook Health Science Centre/University of Toronto, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada.
Janet
J
Ellis
Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
Shao Hui
SH
Huang
Department of Biostatistics, Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
Eshetu G
EG
Atenafu
Department of Medical Oncology, Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, ON, Canada.
Raymond W
RW
Jang
Department of Supportive Care, Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
Gary
G
Rodin
Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, ON, M5G 2M9, Canada. Jolie.ringash@rmp.uhn.on.ca.
Jolie
J
Ringash
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000628:therapy*; D016022:Case-Control Studies; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome; D055815:Young Adult
Head and neck cancer; Radiotherapy; Supportive interventions