Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: a retrospective review.

2.50
Hdl Handle:
http://hdl.handle.net/10541/72528
Title:
Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: a retrospective review.
Authors:
Mangar, Stephen A; Slevin, Nicholas J ( 0000-0002-3367-7013 ) ; Mais, Kathleen L; Sykes, Andrew J
Abstract:
BACKGROUND AND PURPOSE: To identify objective pre-treatment clinical parameters that could be used to predict for patients at high risk of requiring enteral tube feeding prior to head and neck radiotherapy. PATIENTS AND METHODS: A retrospective study was conducted on 160 consecutive patients attending for radiotherapy assessment. Regression analysis was used to determine various pre-treatment nutritional and tumour specific parameters associated with the use of enteral nutrition either before (prophylactic) or during (reactive) radiotherapy (RT). The significant parameters identified were then selected into categorical variables and compared between those who needed reactive enteral nutrition and the remainder of the group who did not. These results were used to generate predictive factors that could be used to identify those at high risk of malnutrition during RT for whom early or prophylactic enteral nutrition should be considered. RESULTS: Fifty patients required enteral feeding of which 60% required this prior to radiotherapy. Multivariate analysis identified the following factors to be significant--body mass index, performance status (PS), advanced stage, pre-treatment weight loss, low serum albumin and protein, age, and smoking. The most significant categorical predictive parameters for reactive enteral feeding were stage 3-4 disease, PS 2-3, and smoking >20/day. The combination of these factors predicted a 75% chance of needing enteral nutrition. CONCLUSION: Nutritional assessment is important prior to radiotherapy and is multifactorial. Using a combination of relatively simple and objective parameters, (performance status, smoking and disease stage) it is possible to identify those at high risk of needing enteral nutrition prior to starting RT.
Affiliation:
Department of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK. stephenmangar@supaworld.com
Citation:
Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: a retrospective review. 2006, 78 (2):152-8 Radiother Oncol
Journal:
Radiotherapy and Oncology
Issue Date:
Feb-2006
URI:
http://hdl.handle.net/10541/72528
DOI:
10.1016/j.radonc.2005.12.014
PubMed ID:
16466819
Type:
Article
Language:
en
ISSN:
0167-8140
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMangar, Stephen A-
dc.contributor.authorSlevin, Nicholas J-
dc.contributor.authorMais, Kathleen L-
dc.contributor.authorSykes, Andrew J-
dc.date.accessioned2009-07-06T08:54:52Z-
dc.date.available2009-07-06T08:54:52Z-
dc.date.issued2006-02-
dc.identifier.citationEvaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: a retrospective review. 2006, 78 (2):152-8 Radiother Oncolen
dc.identifier.issn0167-8140-
dc.identifier.pmid16466819-
dc.identifier.doi10.1016/j.radonc.2005.12.014-
dc.identifier.urihttp://hdl.handle.net/10541/72528-
dc.description.abstractBACKGROUND AND PURPOSE: To identify objective pre-treatment clinical parameters that could be used to predict for patients at high risk of requiring enteral tube feeding prior to head and neck radiotherapy. PATIENTS AND METHODS: A retrospective study was conducted on 160 consecutive patients attending for radiotherapy assessment. Regression analysis was used to determine various pre-treatment nutritional and tumour specific parameters associated with the use of enteral nutrition either before (prophylactic) or during (reactive) radiotherapy (RT). The significant parameters identified were then selected into categorical variables and compared between those who needed reactive enteral nutrition and the remainder of the group who did not. These results were used to generate predictive factors that could be used to identify those at high risk of malnutrition during RT for whom early or prophylactic enteral nutrition should be considered. RESULTS: Fifty patients required enteral feeding of which 60% required this prior to radiotherapy. Multivariate analysis identified the following factors to be significant--body mass index, performance status (PS), advanced stage, pre-treatment weight loss, low serum albumin and protein, age, and smoking. The most significant categorical predictive parameters for reactive enteral feeding were stage 3-4 disease, PS 2-3, and smoking >20/day. The combination of these factors predicted a 75% chance of needing enteral nutrition. CONCLUSION: Nutritional assessment is important prior to radiotherapy and is multifactorial. Using a combination of relatively simple and objective parameters, (performance status, smoking and disease stage) it is possible to identify those at high risk of needing enteral nutrition prior to starting RT.en
dc.language.isoenen
dc.subjectHead and Neck Canceren
dc.subjectMouth Canceren
dc.subjectPharyngeal Canceren
dc.subjectCancer Stagingen
dc.subject.meshAdult-
dc.subject.meshAge Factors-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshBlood Proteins-
dc.subject.meshBody Mass Index-
dc.subject.meshCohort Studies-
dc.subject.meshEnteral Nutrition-
dc.subject.meshForecasting-
dc.subject.meshHead and Neck Neoplasms-
dc.subject.meshHumans-
dc.subject.meshLaryngeal Neoplasms-
dc.subject.meshMalnutrition-
dc.subject.meshMiddle Aged-
dc.subject.meshMouth Neoplasms-
dc.subject.meshNeoplasm Staging-
dc.subject.meshNutrition Assessment-
dc.subject.meshPharyngeal Neoplasms-
dc.subject.meshRetrospective Studies-
dc.subject.meshRisk Factors-
dc.subject.meshSerum Albumin-
dc.subject.meshSeverity of Illness Index-
dc.subject.meshSmoking-
dc.subject.meshWeight Loss-
dc.titleEvaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: a retrospective review.en
dc.typeArticleen
dc.contributor.departmentDepartment of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK. stephenmangar@supaworld.comen
dc.identifier.journalRadiotherapy and Oncologyen

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