Abstract
Objectives/Hypothesis: Mucositis and dysphagia are common complications of chemoradiotherapy (CRT) for head and neck cancer that may necessitate nutritional support with a gastrostomy tube (G-tube). Methods: We reviewed records of patients who underwent and completed CRT, which included at least one traditional chemotherapeutic, for previously untreated head and neck cancer. G-tubes were placed as needed. The timing and duration of G-tube placement and treatment-related complications and risk factors for long-term G-tube use were analyzed. Results: A total of 91 consecutive patients who received CRT, 68 as primary and 23 as postoperative treatment, were studied. Radiation doses ranged from 59.4 to 74 Gy (median, 70 Gy). Seventy-nine percent of patients received platinum-based therapy during CRT. Severe mucositis occurred in 40% of patients. Forty percent of patients required G-tube placement (15 prior to CRT and 21 during CRT). Median duration of G-tube use was 5.8 months. Two patients who had a G-tube placed during CRT developed a G-tube-related complication. At 6 and 12 months, 15 (18%) and four (6%) patients who were disease free were using G-tubes, respectively. Patients with G-tubes placed prior to CRT or advanced T stage had longer G-tube dependence. Conclusions: With aggressive supportive care it is feasible to avoid G-tubes in the majority of patients undergoing CRT for head and neck cancer. G-tube placement prior to CRT due to pre-existing dysphagia and advanced T stage are associated with prolonged G-tube dependence.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 71-75 |
| Number of pages | 5 |
| Journal | Laryngoscope |
| Volume | 120 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2010 |
| Externally published | Yes |
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Keywords
- Chemoradiotherapy
- Gastrostomy tube
- Head and neck cancer
ASJC Scopus subject areas
- Otorhinolaryngology
- Medicine(all)
Cite this
Management of patients treated with chemoradiotherapy for head and neck cancer without prophylactic feeding tubes : The University of Pittsburgh experience. / McLaughlin, Brian T.; Gokhale, Abhay S.; Shuai, Yongli; Diacopoulos, Joyce; Carrau, Ricardo; Heron, Dwight E.; Smith, Ryan P.; Gibson, Michael K.; Ferris, Robert L.; Grandis, Jennifer R.; Johnson, Jonas T.; Argiris, Athanassios.
In: Laryngoscope, Vol. 120, No. 1, 01.2010, p. 71-75.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Management of patients treated with chemoradiotherapy for head and neck cancer without prophylactic feeding tubes
T2 - The University of Pittsburgh experience
AU - McLaughlin, Brian T.
AU - Gokhale, Abhay S.
AU - Shuai, Yongli
AU - Diacopoulos, Joyce
AU - Carrau, Ricardo
AU - Heron, Dwight E.
AU - Smith, Ryan P.
AU - Gibson, Michael K.
AU - Ferris, Robert L.
AU - Grandis, Jennifer R.
AU - Johnson, Jonas T.
AU - Argiris, Athanassios
PY - 2010/1
Y1 - 2010/1
N2 - Objectives/Hypothesis: Mucositis and dysphagia are common complications of chemoradiotherapy (CRT) for head and neck cancer that may necessitate nutritional support with a gastrostomy tube (G-tube). Methods: We reviewed records of patients who underwent and completed CRT, which included at least one traditional chemotherapeutic, for previously untreated head and neck cancer. G-tubes were placed as needed. The timing and duration of G-tube placement and treatment-related complications and risk factors for long-term G-tube use were analyzed. Results: A total of 91 consecutive patients who received CRT, 68 as primary and 23 as postoperative treatment, were studied. Radiation doses ranged from 59.4 to 74 Gy (median, 70 Gy). Seventy-nine percent of patients received platinum-based therapy during CRT. Severe mucositis occurred in 40% of patients. Forty percent of patients required G-tube placement (15 prior to CRT and 21 during CRT). Median duration of G-tube use was 5.8 months. Two patients who had a G-tube placed during CRT developed a G-tube-related complication. At 6 and 12 months, 15 (18%) and four (6%) patients who were disease free were using G-tubes, respectively. Patients with G-tubes placed prior to CRT or advanced T stage had longer G-tube dependence. Conclusions: With aggressive supportive care it is feasible to avoid G-tubes in the majority of patients undergoing CRT for head and neck cancer. G-tube placement prior to CRT due to pre-existing dysphagia and advanced T stage are associated with prolonged G-tube dependence.
AB - Objectives/Hypothesis: Mucositis and dysphagia are common complications of chemoradiotherapy (CRT) for head and neck cancer that may necessitate nutritional support with a gastrostomy tube (G-tube). Methods: We reviewed records of patients who underwent and completed CRT, which included at least one traditional chemotherapeutic, for previously untreated head and neck cancer. G-tubes were placed as needed. The timing and duration of G-tube placement and treatment-related complications and risk factors for long-term G-tube use were analyzed. Results: A total of 91 consecutive patients who received CRT, 68 as primary and 23 as postoperative treatment, were studied. Radiation doses ranged from 59.4 to 74 Gy (median, 70 Gy). Seventy-nine percent of patients received platinum-based therapy during CRT. Severe mucositis occurred in 40% of patients. Forty percent of patients required G-tube placement (15 prior to CRT and 21 during CRT). Median duration of G-tube use was 5.8 months. Two patients who had a G-tube placed during CRT developed a G-tube-related complication. At 6 and 12 months, 15 (18%) and four (6%) patients who were disease free were using G-tubes, respectively. Patients with G-tubes placed prior to CRT or advanced T stage had longer G-tube dependence. Conclusions: With aggressive supportive care it is feasible to avoid G-tubes in the majority of patients undergoing CRT for head and neck cancer. G-tube placement prior to CRT due to pre-existing dysphagia and advanced T stage are associated with prolonged G-tube dependence.
KW - Chemoradiotherapy
KW - Gastrostomy tube
KW - Head and neck cancer
UR - http://www.scopus.com/inward/record.url?scp=74049142052&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=74049142052&partnerID=8YFLogxK
U2 - 10.1002/lary.20697
DO - 10.1002/lary.20697
M3 - Article
C2 - 19877245
AN - SCOPUS:74049142052
VL - 120
SP - 71
EP - 75
JO - Laryngoscope
JF - Laryngoscope
SN - 0023-852X
IS - 1
ER -