The Role of Pretreatment Percutaneous Endoscopic Gastrostomy in Facilitating Therapy of Head and Neck Cancer and Optimizing the Body Mass Index of the Obese Patient

2009 ◽  
Vol 33 (4) ◽  
pp. 404-410 ◽  
Author(s):  
Aleksandra Raykher ◽  
Lilia Correa ◽  
Lianne Russo ◽  
Pat Brown ◽  
Nancy Lee ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Obese Patient ◽  
Body Mass ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Neck Cancer ◽  
The Body ◽  
Endoscopic Gastrostomy

scholarly journals Feasibility of assessing patient health benefits and incurred costs resulting from early dysphagia intervention during and immediately after chemoradiotherapy for head-and-neck cancer

2017 ◽  
Vol 24 (6) ◽  
pp. 466 ◽  
Author(s):  
R. Martino ◽  
J. Ringash ◽  
L. Durkin ◽  
E. Greco ◽  
S. Hui Huang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Body Mass ◽  
Neck Cancer ◽  
Swallowing Function ◽  
Endoscopic Gastrostomy ◽  
Patient Health ◽  
Accrual Rate ◽  
Related Quality

Background Resource limitations affect the intensity of speech–language pathology (slp) dysphagia interventions for patients with head-and-neck cancer (hnc). The objective of the present study was to assess the feasibility of a prospective clinical trial that would evaluate the effects on health and patient costs of early slp dysphagia interventionfor hnc patients planned for curative concurrent chemoradiotherapy (ccrt).Methods Patients with hnc planned for curative ccrt were consecutively recruited and received dysphagia-specific intervention before, during, and for 3 months after treatment. Swallowing function, body mass index, health-related quality of life (qol), and out-of-pocket costs were measured before ccrt, at weeks 2 and 5 during ccrt, and at 1 and 3 months after ccrt. Actuarial percutaneous endoscopic gastrostomy (peg) removal rates and body mass index in the study patients and in a time-, age-, and disease-matched cohort were compared.Results The study enrolled 21 patients (mean age: 54 years; 19 men). The study was feasible, having a 95% accrual rate, 10% attrition, and near completion of all outcomes. Compared with the control cohort, patients receiving dysphagia intervention trended toward a higher rate of peg removal at 3 months after ccrt [61% (32%–78%) vs. 53% (23%–71%), p = 0.23]. During ccrt, monthly pharmaceutical costs ranged between $239 and $348, with work loss in the range of 18–30 days for patients and 8–12 days for caregivers.Conclusions We demonstrated the feasibility of comparing health and economic outcomes in patients receiving and not receiving early slp dysphagia intervention. These preliminary findings suggest that early slp dysphagia intervention for hnc patients might reduce peg dependency despite worsening health. Findings also highlight effects on financial security for these patients and their caregivers.

Effect of Body Mass Index on Chemoradiation Outcomes in Head and Neck Cancer

2008 ◽  
Vol 118 (7) ◽  
pp. 1180-1185 ◽  
Author(s):  
Theodore R. McRackan ◽  
John M. Watkins ◽  
Amy E. Herrin ◽  
Elizabeth M. Garrett-Mayer ◽  
Anand K. Sharma ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Body Mass ◽  
Neck Cancer

scholarly journals A Bayesian Sensitivity Analysis to Partition Body Mass Index Into Components of Body Composition: An Application to Head and Neck Cancer Survival

2019 ◽  
Vol 188 (11) ◽  
pp. 2031-2039
Author(s):  
Patrick T Bradshaw ◽  
Jose P Zevallos ◽  
Kathy Wisniewski ◽  
Andrew F Olshan
Keyword(s):  
Body Mass Index ◽  
Sensitivity Analysis ◽  
Body Composition ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Body Mass ◽  
Neck Cancer ◽  
Hazard Ratio ◽  
Unit Increase ◽  
The Relationship

Abstract Previous studies have suggested a “J-shaped” relationship between body mass index (BMI, calculated as weight (kg)/height (m)2) and survival among head and neck cancer (HNC) patients. However, BMI is a vague measure of body composition. To provide greater resolution, we used Bayesian sensitivity analysis, informed by external data, to model the relationship between predicted fat mass index (FMI, adipose tissue (kg)/height (m)2), lean mass index (LMI, lean tissue (kg)/height (m)2), and survival. We estimated posterior median hazard ratios and 95% credible intervals for the BMI-mortality relationship in a Bayesian framework using data from 1,180 adults in North Carolina with HNC diagnosed between 2002 and 2006. Risk factors were assessed by interview shortly after diagnosis and vital status through 2013 via the National Death Index. The relationship between BMI and all-cause mortality was convex, with a nadir at 28.6, with greater risk observed throughout the normal weight range. The sensitivity analysis indicated that this was consistent with opposing increases in risk with FMI (per unit increase, hazard ratio = 1.04 (1.00, 1.08)) and decreases with LMI (per unit increase, hazard ratio = 0.90 (0.85, 0.95)). Patterns were similar for HNC-specific mortality but associations were stronger. Measures of body composition, rather than BMI, should be considered in relation to mortality risk.

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