T E Brown1,2, V Getliffe2, M D Banks1, B G M Hughes3,4, C Y Lin3, L M Kenny3, J D Bauer2. 1. Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. 2. Centre for Dietetics Research (C-DIET-R), School of Human Movement Studies, University of Queensland, Brisbane, QLD, Australia. 3. Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. 4. School of Medicine, University of Queensland, Brisbane, QLD, Australia.
Abstract
BACKGROUND/ OBJECTIVES: Evidence-based practice guidelines are available to assist in the decision making for nutrition interventions in patients with head and neck cancer. Re-assessment of guideline recommendations is important with changing demographics, new treatment regimens, advancing radiotherapy techniques, such as helical intensity-modulated radiotherapy, and the emergence of new literature. The aim of this study was to validate the updated high-risk category definition in our local hospital protocol for the swallowing and nutrition management of patients with head and neck cancer to determine the ongoing predictive ability for identifying proactive gastrostomy requirement in a new cohort. SUBJECTS/ METHODS: Patients attending a major tertiary hospital for head and neck cancer treatment from 2010 to 2011 were included (n=270). Data were collected on patient demographics (age and gender), clinical factors (tumour site, staging and treatment), nutrition outcome measures (weight, enteral feeding) and protocol adherence. Sensitivity and specificity were calculated and compared with the original validation study. RESULTS: Proactive gastrostomy tubes were inserted in 86 patients. Overall protocol adherence was 93%. Sensitivity improved to 72% (increase of 18%) and specificity improved to 96% (increase of 3%) compared with the original validation study where patients received three-dimensional (3-D) conformal radiotherapy. CONCLUSIONS: The results of this study confirm that the updated high-risk category in the protocol for the swallowing and nutrition management of patients with head and neck cancer remains valid to predict proactive gastrostomy in a mixed population receiving helical intensity-modulated radiotherapy and 3-D conformal radiotherapy. The protocol has an improved sensitivity and specificity and hence remains just as relevant for advanced techniques of radiation treatment delivery.
BACKGROUND/ OBJECTIVES: Evidence-based practice guidelines are available to assist in the decision making for nutrition interventions in patients with head and neck cancer. Re-assessment of guideline recommendations is important with changing demographics, new treatment regimens, advancing radiotherapy techniques, such as helical intensity-modulated radiotherapy, and the emergence of new literature. The aim of this study was to validate the updated high-risk category definition in our local hospital protocol for the swallowing and nutrition management of patients with head and neck cancer to determine the ongoing predictive ability for identifying proactive gastrostomy requirement in a new cohort. SUBJECTS/ METHODS:Patients attending a major tertiary hospital for head and neck cancer treatment from 2010 to 2011 were included (n=270). Data were collected on patient demographics (age and gender), clinical factors (tumour site, staging and treatment), nutrition outcome measures (weight, enteral feeding) and protocol adherence. Sensitivity and specificity were calculated and compared with the original validation study. RESULTS: Proactive gastrostomy tubes were inserted in 86 patients. Overall protocol adherence was 93%. Sensitivity improved to 72% (increase of 18%) and specificity improved to 96% (increase of 3%) compared with the original validation study where patients received three-dimensional (3-D) conformal radiotherapy. CONCLUSIONS: The results of this study confirm that the updated high-risk category in the protocol for the swallowing and nutrition management of patients with head and neck cancer remains valid to predict proactive gastrostomy in a mixed population receiving helical intensity-modulated radiotherapy and 3-D conformal radiotherapy. The protocol has an improved sensitivity and specificity and hence remains just as relevant for advanced techniques of radiation treatment delivery.
Authors: Matthew C Ward; Priyanka Bhateja; Tobenna Nwizu; Joann Kmiecik; Chandana A Reddy; Joseph Scharpf; Eric D Lamarre; Brian B Burkey; John F Greskovich; David J Adelstein; Shlomo A Koyfman Journal: Head Neck Date: 2015-09-02 Impact factor: 3.147
Authors: Brett G M Hughes; Vikram K Jain; Teresa Brown; Ann-Louise Spurgin; Gemma Hartnett; Jacqui Keller; Lee Tripcony; Mark Appleyard; Robert Hodge Journal: Head Neck Date: 2012-05-18 Impact factor: 3.147
Authors: Paul B Romesser; Jonathan C Romanyshyn; Karen D Schupak; Jeremy Setton; Nadeem Riaz; Suzanne L Wolden; Daphna Y Gelblum; Eric J Sherman; Dennis Kraus; Nancy Y Lee Journal: Cancer Date: 2012-06-15 Impact factor: 6.860
Authors: Marco van Vulpen; Colin Field; Cornelis P J Raaijmakers; Matthew B Parliament; Chris H J Terhaard; Marc A MacKenzie; Rufus Scrimger; Jan J W Lagendijk; B Gino Fallone Journal: Int J Radiat Oncol Biol Phys Date: 2005-08-01 Impact factor: 7.038
Authors: J Arends; G Bodoky; F Bozzetti; K Fearon; M Muscaritoli; G Selga; M A E van Bokhorst-de van der Schueren; M von Meyenfeldt; G Zürcher; R Fietkau; E Aulbert; B Frick; M Holm; M Kneba; H J Mestrom; A Zander Journal: Clin Nutr Date: 2006-05-12 Impact factor: 7.324
Authors: Juliana Bonilla-Velez; Edmund A Mroz; Rebecca J Hammon; James W Rocco Journal: Otolaryngol Clin North Am Date: 2013-06-27 Impact factor: 3.346
Authors: Marije R Vergeer; Patricia A H Doornaert; Derek H F Rietveld; C René Leemans; Ben J Slotman; Johannes A Langendijk Journal: Int J Radiat Oncol Biol Phys Date: 2008-12-26 Impact factor: 7.038
Authors: Mererid Evans; Robert Newcombe; Alison Fiander; James Powell; Martin Rolles; Selvam Thavaraj; Max Robinson; Ned Powell Journal: BMC Cancer Date: 2013-05-01 Impact factor: 4.430
Authors: Laura W J Baijens; Margaret Walshe; Leena-Maija Aaltonen; Christoph Arens; Reinie Cordier; Patrick Cras; Lise Crevier-Buchman; Chris Curtis; Wojciech Golusinski; Roganie Govender; Jesper Grau Eriksen; Kevin Hansen; Kate Heathcote; Markus M Hess; Sefik Hosal; Jens Peter Klussmann; C René Leemans; Denise MacCarthy; Beatrice Manduchi; Jean-Paul Marie; Reza Nouraei; Claire Parkes; Christina Pflug; Walmari Pilz; Julie Regan; Nathalie Rommel; Antonio Schindler; Annemie M W J Schols; Renee Speyer; Giovanni Succo; Irene Wessel; Anna C H Willemsen; Taner Yilmaz; Pere Clavé Journal: Eur Arch Otorhinolaryngol Date: 2020-12-19 Impact factor: 2.503
Authors: Teresa E Brown; Merrilyn D Banks; Brett G M Hughes; Charles Y Lin; Lizbeth M Kenny; Judith D Bauer Journal: Br J Cancer Date: 2017-05-23 Impact factor: 7.640