Skip to main content
Top
Published in: Supportive Care in Cancer 2/2015

01-02-2015 | Original Article

Factors associated with gastrostomy tube dependence after concurrent chemoradiotherapy for hypopharyngeal cancer

Authors: Shigeyuki Murono, Akira Tsuji, Kazuhira Endo, Satoru Kondo, Naohiro Wakisaka, Tomokazu Yoshizaki

Published in: Supportive Care in Cancer | Issue 2/2015

Login to get access

Abstract

Purpose

We aimed to identify tumor- and treatment-related factors predicting gastrostomy tube dependence after concurrent chemoradiotherapy (CCRT) for hypopharyngeal cancer.

Methods

We performed a retrospective review of all patients with hypopharyngeal cancer treated with CCRT between 2002 and 2012 except for those with residual or recurrent disease at evaluation. The incidence of gastrostomy tube dependence, defined as complete or almost complete dependence on tube feeding, at 6 months after the completion of treatment was the endpoint. A total of 75 patients were analyzed in this study.

Results

Twelve patients (16 %) showed gastrostomy tube dependence. Among tumor-related factors, the subsite (posterior wall versus pyriform sinus plus postcricoid) was the most significant factor correlated with gastrostomy tube dependence (p < 0.01 by multivariate analysis). The T category of the primary tumor was also correlated with gastrostomy tube dependence on univariate analysis (p < 0.01). Among treatment-related factors, the radiation dose was not associated with gastrostomy tube dependence. On the other hand, gastrostomy tube dependence was also correlated with the requirement of supportive nutrition with a nasogastric tube at the beginning of and during treatment (both p < 0.01).

Conclusion

Risk factors for gastrostomy tube dependence after the completion of CCRT for hypopharyngeal cancer were identified.
Literature
1.
go back to reference Pignon JP, Bourhis J, Domenge C, Designe L (2000) Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. Lancet 355:949–955PubMedCrossRef Pignon JP, Bourhis J, Domenge C, Designe L (2000) Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. Lancet 355:949–955PubMedCrossRef
2.
go back to reference Pignon JP, le Maitre A, Maillard E, Bourhis J (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92:4–14 Pignon JP, le Maitre A, Maillard E, Bourhis J (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92:4–14
3.
go back to reference Robbins KT (2002) Barriers to winning the battle with head-and-neck cancer. Int J Radiat Oncol Biol Phys 53:4–5 Robbins KT (2002) Barriers to winning the battle with head-and-neck cancer. Int J Radiat Oncol Biol Phys 53:4–5
4.
go back to reference Samant S, Kumar P, Wan J, Hanchett C, Vieira F, Murry T et al (1999) Concomitant radiation therapy and targeted cisplatin chemotherapy for the treatment of advanced pyriform sinus carcinoma: disease control and preservation of organ function. Head Neck 7:595–601 Samant S, Kumar P, Wan J, Hanchett C, Vieira F, Murry T et al (1999) Concomitant radiation therapy and targeted cisplatin chemotherapy for the treatment of advanced pyriform sinus carcinoma: disease control and preservation of organ function. Head Neck 7:595–601
5.
go back to reference Bhayani MK, Hutcheson KA, Barringer DA, Roberts DB, Lewin JS, Lai SY (2013) Gastrostomy tube placement in patients with hypopharyngeal cancer treated with radiotherapy or chemoradiotherapy: factors affecting placement and dependence. Head Neck 35:1641–1646PubMedCrossRef Bhayani MK, Hutcheson KA, Barringer DA, Roberts DB, Lewin JS, Lai SY (2013) Gastrostomy tube placement in patients with hypopharyngeal cancer treated with radiotherapy or chemoradiotherapy: factors affecting placement and dependence. Head Neck 35:1641–1646PubMedCrossRef
6.
go back to reference Henk JM (1997) Controlled trials of synchronous chemotherapy with radiotherapy in head and neck cancer: overview of radiation morbidity. Clin Oncol (R Coll Radiol) 9:308–312 Henk JM (1997) Controlled trials of synchronous chemotherapy with radiotherapy in head and neck cancer: overview of radiation morbidity. Clin Oncol (R Coll Radiol) 9:308–312
7.
go back to reference Machtay M, Moughan J, Trotti A, Garden AS, Weber RS, Cooper JS et al (2008) Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol 26:3582–3589PubMedCrossRef Machtay M, Moughan J, Trotti A, Garden AS, Weber RS, Cooper JS et al (2008) Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol 26:3582–3589PubMedCrossRef
8.
go back to reference Bradley PT, Bradley PJ (2012) Treatment of hypopharyngeal carcinoma with primary chemoradiotherapy: functional morbidity. Curr Opin Otolaryngol Head Neck Surg 20:89–96PubMedCrossRef Bradley PT, Bradley PJ (2012) Treatment of hypopharyngeal carcinoma with primary chemoradiotherapy: functional morbidity. Curr Opin Otolaryngol Head Neck Surg 20:89–96PubMedCrossRef
9.
go back to reference Lee WT, Akst LM, Adelstein DJ, Saxton JP, Wood BG, Strome M et al (2006) Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation. Head Neck 28:808–812PubMedCrossRef Lee WT, Akst LM, Adelstein DJ, Saxton JP, Wood BG, Strome M et al (2006) Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation. Head Neck 28:808–812PubMedCrossRef
10.
go back to reference Agarwal J, Palwe V, Dutta D, Gupta T, Laskar SG, Budrukkar A et al (2011) Objective assessment of swallowing function after definitive concurrent (chemo)radiotherapy in patients with head and neck cancer. Dysphagia 26:399–406 Agarwal J, Palwe V, Dutta D, Gupta T, Laskar SG, Budrukkar A et al (2011) Objective assessment of swallowing function after definitive concurrent (chemo)radiotherapy in patients with head and neck cancer. Dysphagia 26:399–406
11.
go back to reference Mekhail TM, Adelstein DJ, Rybicki LA, Larto MA, Saxton JP, Lavertu P (2001) Enteral nutrition during the treatment of head and neck carcinoma: is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube? Cancer 91:1785–1790PubMedCrossRef Mekhail TM, Adelstein DJ, Rybicki LA, Larto MA, Saxton JP, Lavertu P (2001) Enteral nutrition during the treatment of head and neck carcinoma: is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube? Cancer 91:1785–1790PubMedCrossRef
12.
go back to reference Machtay M, Moughan M, Farach A, Martin-O’Meara E, Galvin J, Garden AS et al (2012) Hypopharyngeal dose is associated with severe late toxicity in locally advanced head-and-neck cancer: an RTOG analysis. Int J Radiat Oncol Biol Phys 84:983–989PubMedCentralPubMedCrossRef Machtay M, Moughan M, Farach A, Martin-O’Meara E, Galvin J, Garden AS et al (2012) Hypopharyngeal dose is associated with severe late toxicity in locally advanced head-and-neck cancer: an RTOG analysis. Int J Radiat Oncol Biol Phys 84:983–989PubMedCentralPubMedCrossRef
13.
go back to reference Ames JA, Karnell LH, Gupta AK, Coleman TC, Karnell MP, Van Daele DJ et al (2011) Outcomes after the use of gastrostomy tubes in patients whose head and neck cancer was managed with radiation therapy. Head Neck 33:638–644PubMedCrossRef Ames JA, Karnell LH, Gupta AK, Coleman TC, Karnell MP, Van Daele DJ et al (2011) Outcomes after the use of gastrostomy tubes in patients whose head and neck cancer was managed with radiation therapy. Head Neck 33:638–644PubMedCrossRef
14.
go back to reference Paximadis P, Yoo G, Lin HS, Jacobs J, Sukari A, Dyson G et al (2012) Concurrent chemoradiotherapy improves survival in patients with hypopharyngeal cancer. Int J Radiat Oncol Biol Phys 82:1515–1521 Paximadis P, Yoo G, Lin HS, Jacobs J, Sukari A, Dyson G et al (2012) Concurrent chemoradiotherapy improves survival in patients with hypopharyngeal cancer. Int J Radiat Oncol Biol Phys 82:1515–1521
15.
go back to reference Nomura K, Takahara M, Katayama A, Kishibe K, Kunibe I, Katada A et al (2013) Intra-arterial cisplatin with concomitant radiation for advanced hypopharyngeal cancer. Laryngoscope 123:916–922PubMedCrossRef Nomura K, Takahara M, Katayama A, Kishibe K, Kunibe I, Katada A et al (2013) Intra-arterial cisplatin with concomitant radiation for advanced hypopharyngeal cancer. Laryngoscope 123:916–922PubMedCrossRef
16.
go back to reference Platteaux N, Dirix P, Dejaeger E, Nuyts S (2010) Dysphagia in head and neck cancer patients treated with chemoradiotherapy. Dysphagia 25:139–152PubMedCrossRef Platteaux N, Dirix P, Dejaeger E, Nuyts S (2010) Dysphagia in head and neck cancer patients treated with chemoradiotherapy. Dysphagia 25:139–152PubMedCrossRef
Metadata
Title
Factors associated with gastrostomy tube dependence after concurrent chemoradiotherapy for hypopharyngeal cancer
Authors
Shigeyuki Murono
Akira Tsuji
Kazuhira Endo
Satoru Kondo
Naohiro Wakisaka
Tomokazu Yoshizaki
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 2/2015
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-014-2388-8

Other articles of this Issue 2/2015

Supportive Care in Cancer 2/2015 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine