Weight Loss and Percutaneous Endoscopic Gastrostomy Tube Placement during Chemoradiotherapy for Locally Advanced Cancer of the Oropharynx Do Not Negatively Impact Outcomes

Frontiers in Oncology

Lynette Smith¹  Timothy Dorius²  Apar Kishor Ganti²  Nathan Bennion³  Weining Zhen³  Michael J. Baine³ 

[1] Center for Collaboration on Research Design and Analysis, Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States;Department of Medical Oncology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, United States;Department of Radiation Oncology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, United States;

关键词: head and neck cancer;    squamous cell carcinoma;    oropharyngeal cancer;    toxicity;    chemoradiotherapy;   

DOI  :  10.3389/fonc.2017.00299

来源: DOAJ

【 摘 要 】

ObjectivesConcurrent chemoradiotherapy is standard of care in locally advanced oropharyngeal cancer (LA-OPC). This treatment regimen results in significant acute toxicities. This study investigates the effect of treatment-related toxicity on patient outcomes.MethodsPatient information was retrospectively collected for patients treated for LA-OPC between 2007 and 2014. Factors analyzed included age, gender, pretreatment ECOG performance status, smoking history, patient BMI prior to and following treatment, tumor histology, disease stage, disease recurrence, incidence, and timing of feeding tube placement, radiation dose received, chemotherapy regimen used and if it was completed, and patient survival. All statistical analysis was provided through the University of Nebraska Medical Center Department of Biostatistics.Results74 patients were identified with a median follow-up of 3.4 years and a median age of 58.5. Most patients were male (87.8%) and had squamous cell histology (98.7%). Most patients underwent chemoradiotherapy alone (98.6%) and received concurrent cisplatin (78.4%) with approximately half (53.4%) receiving all planned chemotherapy. Upon multivariate analysis, both disease-free (DFS) and overall survival (OS) rates were improved by lower pretreatment BMI, increased weight lost during treatment, and lack of percutaneous endoscopic gastrostomy (PEG) tube placement prior to treatment initiation. Neither DFS nor OS was impacted by placement of a PEG tube during active treatment.ConclusionThese data suggest that weight loss and PEG tube placement during chemoradiotherapy for LA-OPC, presumably due to treatment-associated mucositis and xerostomia, are not associated with worse outcomes.

【 授权许可】

Unknown