Weight loss and percutaneous endoscopic gastrostomy tube placement during chemoradiotherapy for locally advanced cancer of the oropharynx do not negatively impact outcomes

Michael J. Baine, Timothy Dorius, Nathan Bennion, Lynette M Smith, Weining Zhen, Apar Kishor P Ganti

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: Concurrent 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. Methods: Patient 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. Results: 74 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. Conclusion: These 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.

Original languageEnglish (US)
Article number299
JournalFrontiers in Oncology
Volume7
Issue numberDEC
DOIs
StatePublished - Dec 5 2017

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Oropharyngeal Neoplasms
Gastrostomy
Chemoradiotherapy
Weight Loss
Therapeutics
Histology
Biostatistics
Drug Therapy
Xerostomia
Mucositis
Survival
Enteral Nutrition
Standard of Care
Cisplatin
Multivariate Analysis
Survival Rate
Smoking
History
Epithelial Cells
Radiation

Keywords

  • Chemoradiotherapy
  • Head and neck cancer
  • Oropharyngeal cancer
  • Squamous cell carcinoma
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{74fa2af404e54beea5c5fb8131f0568a,
title = "Weight loss and percutaneous endoscopic gastrostomy tube placement during chemoradiotherapy for locally advanced cancer of the oropharynx do not negatively impact outcomes",
abstract = "Objectives: Concurrent 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. Methods: Patient 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. Results: 74 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. Conclusion: These 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.",
keywords = "Chemoradiotherapy, Head and neck cancer, Oropharyngeal cancer, Squamous cell carcinoma, Toxicity",
author = "Baine, {Michael J.} and Timothy Dorius and Nathan Bennion and Smith, {Lynette M} and Weining Zhen and Ganti, {Apar Kishor P}",
year = "2017",
month = "12",
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doi = "10.3389/fonc.2017.00299",
language = "English (US)",
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journal = "Frontiers in Oncology",
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TY - JOUR

T1 - Weight loss and percutaneous endoscopic gastrostomy tube placement during chemoradiotherapy for locally advanced cancer of the oropharynx do not negatively impact outcomes

AU - Baine, Michael J.

AU - Dorius, Timothy

AU - Bennion, Nathan

AU - Smith, Lynette M

AU - Zhen, Weining

AU - Ganti, Apar Kishor P

PY - 2017/12/5

Y1 - 2017/12/5

N2 - Objectives: Concurrent 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. Methods: Patient 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. Results: 74 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. Conclusion: These 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.

AB - Objectives: Concurrent 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. Methods: Patient 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. Results: 74 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. Conclusion: These 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.

KW - Chemoradiotherapy

KW - Head and neck cancer

KW - Oropharyngeal cancer

KW - Squamous cell carcinoma

KW - Toxicity

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U2 - 10.3389/fonc.2017.00299

DO - 10.3389/fonc.2017.00299

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