Daily step counts to predict hospitalizations during chemoradiotherapy for head and neck cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1571-1571
Author(s):  
Elena S. Izmailova ◽  
Andrew Cohen ◽  
Rafi Kabarriti ◽  
Jeremy Eichler ◽  
Chengrui Huang ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cox Regression ◽  
Step Count ◽  
Daily Step ◽  
Step Counts ◽  
The Past ◽  
Daily Step Count ◽  
Ecog Ps

1571 Background: Wearable activity trackers could provide useful data for managing cancer patients with respect to treatment selection, toxicity monitoring, and implementation of supportive care measures. Here, we seek to evaluate the association between daily step counts and hospitalizations in a cohort of patients with head and neck cancer (HNC). Methods: This analysis consists of patients enrolled in one of three prospective trials involving activity monitoring (NCT02649569, NCT03115398, NCT03102229) during chemoradiation. Study subjects were asked to wear a commercial fitness tracker continuously during the therapy. ECOG performance status (PS) was assessed at baseline, and quality of life (QoL) EORTC QLQ-C30 questionnaires were completed weekly. Multivariable Cox regression models with time-dependent covariates (average step count over the past 3 days, most recent QoL score) and time-fixed covariates (age, sex, baseline PS, study number, baseline tumor volume, and treatment setting [definitive versus postoperative]) were used to identify predictors of first hospital admission during the chemoradiotherapy course. In addition to the Cox regression models, linear mixed models were fitted with daily step count as the dependent variable to examine its relationship with certain independent variables including age, sex, weekend status, days after treatment initiation, and study number. Results: Sixty-six HNC patients who received chemoradiotherapy between 2015 and 2019 were included in the analysis. Median age was 60 (range: 27-88). 47% of patients had ECOG PS score 0, 47% ECOG score 1, and 6% ECOG score 2. 29% of patients had HPV-positive oropharyngeal tumors, and the most common other tumor subsites were larynx (27%), and nasopharynx (12%). The Cox regression survival model demonstrated a 26% reduction in the short-term hospitalization risk for every 1000 daily steps (averaged over the past 3 days, hazard ratio 0.74; 95% confidence interval (CI) 0.55-0.98, p = 0.0367). Hospitalizations were not significantly associated with most recent QoL or baseline ECOG PS. Additionally, according to the linear mixed model results, daily step count was not associated with age (p = 0.8048). Study subjects moved less on weekends (on average 245 fewer steps on weekends than weekdays, 95% CI 134-357, p < 0.0001). Also, an increase in most recently measured ECOG PS was associated with a decrease in daily step count (167 fewer steps for every increase in ECOG PS, 95% CI -289 to -45, p < 0.0072). Conclusions: Daily step counts are a dynamic predictor of hospitalizations in patients undergoing chemoradiotherapy for head and neck cancer. Interventional studies are needed to demonstrate feasibility of leveraging physical activity data to optimize supportive care during cancer therapy and enhance cancer care quality. Clinical trial information: NCT02649569, NCT03115398, NCT03102229.

scholarly journals Cessation Attitudes and Preferences in Head and Neck Cancer Patients and Implications for Cessation Program Design: A Brief Report

2019 ◽  
Vol 8 ◽  
pp. 216495611984711
Author(s):  
Chandylen L Nightingale ◽  
Katherine R Sterba ◽  
Janet A Tooze ◽  
Jessica L King ◽  
Kathryn E Weaver
Keyword(s):  
Smoking Cessation ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Smoking Status ◽  
Smoking History ◽  
Major Surgery ◽  
Cancer Center ◽  
The Past ◽  
Quit Smoking

Introduction This brief report examined prior cessation attempts, attitudes toward nicotine replacement therapy (NRT), and interests in cessation interventions among head and neck cancer (HNC) patients with a recent smoking history (current smokers and recent quitters). Methods Forty-two HNC patients scheduled for major surgery who reported current or recent (quit <6 months) cigarette smoking participated. Participants completed a survey to assess smoking status, prior cessation attempts, attitudes toward NRT, and interest in and preferences for cessation interventions. Results Patients attempted to quit smoking on average 3.2 times in the past 12 months. Most patients (65.8%) reported that NRT products help people quit, with 42.5% reporting ever using cessation aids/services. Most patients (81.8%) reported interest in a smoking cessation program. Current smokers and recent quitters reported similar cessation attempts, attitudes toward NRT, and interest in smoking cessation interventions. Discussion Cancer center-based smoking cessation interventions are needed for current smokers and recent quitters maintaining cessation.

A Pilot Study Comparing Pedometer Counts with Reported Physical Activity in Elementary Schoolchildren

2004 ◽  
Vol 16 (4) ◽  
pp. 355-367 ◽  
Author(s):  
Greet Cardon ◽  
Ilse De Bourdeaudhuij
Keyword(s):  
Physical Activity ◽  
Pilot Study ◽  
Vigorous Physical Activity ◽  
Step Count ◽  
Regression Equations ◽  
Moderate Correlation ◽  
Daily Step ◽  
Step Counts ◽  
Daily Step Count

In this study pedometer counts were recorded for 6 consecutive days for 92 children (mean age = 9.6 years; range 6.5–12.7) and were compared with the number of minutes per day in which the participants engaged in moderate-to-vigorous physical activity (MVPA). Diaries filled out with the assistance of one of the children’s parents were used to determine minutes of MVPA. The average daily step count was significantly higher in boys than in girls, although the average daily MVPA engagement in minutes did not vary significantly between genders. Based on the regression equations, 60 min of MVPA was equivalent to 15,340 step counts in boys, 11,317 step counts in girls, and 13,130 step counts when results for both genders were combined. A moderate correlation (r = .39, p < .001) was found between pedometer step counts and reported minutes of MVPA. According to the present study findings, however, predictions and promotion of daily MVPA engagement in children based on pedometer counts per day should be made with caution.

scholarly journals Role of systemic inflammatory markers (biomarkers) as important prognostic factors for survival in head and neck cancer

Biomedicine ◽  
2021 ◽  
Vol 41 (4) ◽  
pp. 837-844
Author(s):  
Das Sumana Maiti ◽  
Dharmendra Singh ◽  
Anjana Bose ◽  
Siddhartha Das ◽  
S Neena Prasad ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Prognostic Factors ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Rank Test ◽  
Head Neck Cancer ◽  
Lymphocyte Ratio ◽  
Definitive Therapy

Introduction and Aim: Cancer related inflammation is recognized as a critical multifaceted player in tumour initiation and progression. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are important markers of systemic inflammatory burden in malignancy. The present retrospective study aimed to evaluate the prognostic value of pre-treatment baseline (NLR) and (PLR) for survival in HNC patients.   Materials and Methods: Analysis of data of 257 patients with head and neck cancer treated with definitive therapy over 3.5 yrs. Neutrophil, lymphocyte and platelet counts before treatment of all patients were collected and NLR and PLR were calculated.   Results: Median value of NLR and PLR were 3.7 and 170.63 respectively. Receiver operator characteristics (ROC) curve analysis showed the predictive cut-off value of NLR and PLR as 3.9 and 158.3. Univariate analysis using Cox-regression model showed NLR (p < 0.001) and PLR (p = 0.001) significantly influenced the locoregional recurrence free survival (LRRFS) and overall survival (OS). The multivariate analysis showed NLR is the independent prognostic factors influencing LRRFS (p = 0.007) and OS (p = 0.002). Kaplan-Meier survival curve (Log rank test; Chi-square (?2) value) showed OS is significantly influenced by NLR group (LRRFS; ?2 = 23.9 and OS; ?2 = 33.7) and PLR group (LRRFS; ?2 = 11.2 and OS; ?2 = 19.3) in contrast to LRRFS.   Conclusion: NLR can be strongly used as biomarker for prognostication for outcome and survival in head neck cancer. However, a well-designed, larger studies with longer follow-up is warranted.

Phase II study of capecitabine as palliative treatment for patients (p) with squamous head and neck cancer (HNC) with locoregional and/or metastatic relapse after previous platinum-based treatment (PBT): Final results of Spanish Head and Neck Cancer Group (TTCC)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6047-6047 ◽  
Author(s):  
J. Martinez-Trufero ◽  
D. Isla ◽  
J. C. Adansa ◽  
A. Irigoyen ◽  
R. Hitt ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Palliative Treatment ◽  
Objective Response ◽  
Hematological Toxicity ◽  
Line Treatment ◽  
Metastatic Relapse ◽  
Previously Treated ◽  
Ecog Ps

6047 Background: PBT is widely used as first line treatment in relapsed and/or metastatic HNC. Therefore, new non-platinum drugs need to be asses as second line treatment options. We proposed this study to evaluate activity and tolerability of capecitabine (X) when used as palliative monotherapy for relapsed HNC p previously treated with PBT. Methods: Forty patients (p) aged 18–75 years, ECOG PS 0–2, with advanced squamous HNC with locoregional and/or metastatic relapse previously treated with PBT and adequate bone marrow, renal and hepatic functions were included. X (1,250 mg/m2 BID) during 14 days was administered every 21 days, for at least 2 cycles. RECIST objective response rate (ORR) was assessed and toxicity following NCI-CTC v2 criteria. Results: Forty patients with median age 58 years old, all of them male, ECOG 0–2 (0:25%/1:70%/2:5%) and with squamous HNC, were analyzed. 34 p had local disease, 9 p regional disease and 19 p distant metastases(12 p lung). Median time since HNC diagnosis was 17.7 months and since disease extension diagnosis, 1.1 months. All p received a total of 169 cycles of X (median 4, range 1–9) and the median relative dose intensity was 91%. 7 p were not evaluable for response, since they do not receive at least 3 cycles ( 3 died, 2p due to toxicity, 2p due to decrease in ECOG PS ). ORR was 22.5 %.The median follow-up time was 5.2 months (alive p: 8.8 months), median TTP was 4.6 months and median OS was 6.2 months. Hematological toxicity G3/4 was reported in 6 p. 2p reported as grade 4 non-hematological toxicity: dysphagia and palmar-plantar erythrodysesthesia; grade III toxicities were: asthenia (4 p), anorexia (1 p), dehydratation (1 p), diarrhea (3 p), dysphagia (3 p) mucositis (4 p), weight loss (1 p), and palmar-plantar erythrodysesthesia (3 p). The most common grade II toxicity was asthenia (8 p). Conclusions: Capecitabine seems to be an active, feasible and well tolerated palliative treatment for advanced HNC patients that have previously received platinum-based schedules. No significant financial relationships to disclose.

scholarly journals Patients with Head and Neck cancer in the Past 10 Years

1991 ◽  
Vol 1991 (Supplement41) ◽  
pp. 50-59
Author(s):  
Takashi Okumura ◽  
Kazuyasu Fukuda ◽  
Hideharu Aruga ◽  
Jun-ichi Yoshida ◽  
Mahito Ito ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
The Past

scholarly journals Ambulation Orderlies and Recovery After Cardiac Surgery: A Pilot Randomized Controlled Trial

2017 ◽  
Vol 6 (3) ◽  
pp. 42-49 ◽  
Author(s):  
Quinn R. Pack ◽  
Erin A. Woodbury ◽  
Samuel Headley ◽  
Paul Visintainer ◽  
Richard Engelman ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Barthel Index ◽  
Controlled Trial ◽  
Functional Independence ◽  
Step Count ◽  
Daily Step ◽  
Unique Identifier ◽  
Step Counts ◽  
Daily Step Count ◽  
The Impact

Background: One potential strategy to increasing physical activity after surgery is to use an ambulation orderly (AO), a dedicated employee who assures frequent patient walking. However, the impact of an AO on physical and functional recovery from surgery is unknown. Methods: We randomized postoperative cardiac surgical patients to receive either the AO or usual care. We measured average daily step count, changes in 6-min walk test (6MWT) distance, and changes in functional independence (Barthel Index). Our primary goal was to test protocols, measure variability in activity, and establish effect sizes. Results: Thirty-six patients were randomized (18 per group, 45% bypass surgery). Overall, patients exhibited significant recovery of physical function from baseline to discharge in the 6MWT (from 83 to 172 meters, p &lt; 0.001) and showed improvement in independent function (Barthel Index, 67 to 87, p &lt; 0.001). Moreover, each additional barrier to ambulation (supplemental oxygen, intravenous poles/fluid, walkers, urinary catheters, and chest tubes) reduced average daily step count by 330 steps/barrier, p = 0.04. However, the AO intervention resulted in only a small difference in average daily step counts (2718 versus 2541 steps/d, Cohen's d = 0.16, 608 patients needed for larger trial), which we attributed to several trial factors that likely weakened the AO intervention. Conclusion: In this pilot study, we observed significant in-hospital physical and functional recovery from surgery, but the addition of an AO made only marginal differences in daily step counts. Future studies should consider stepped-wedge or cluster trial designs to increase intervention effectiveness. Clinical Trials Registration: Clinicaltrials.gov unique identifier: NCT02375282.

Utilization and Survival of Postoperative Radiation or Chemoradiation for pT1-2N1M0 Head and Neck Cancer

2017 ◽  
Vol 158 (4) ◽  
pp. 677-684 ◽  
Author(s):  
Anna Lee ◽  
Babak Givi ◽  
Dylan F. Roden ◽  
Moses M. Tam ◽  
S. Peter Wu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Logistic Regression ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Odds Ratio ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Postoperative Treatment ◽  
Extracapsular Extension

Objective To analyze the patterns of care and survival for pT1-2N1M0 head and neck cancer based on receipt of surgery alone, surgery + postoperative radiotherapy (S + RT), or surgery + postoperative chemoradiotherapy (S + CRT). Study Design Retrospective analysis. Setting National Cancer Database. Subjects and Methods We queried the database for patients with stage pT1-2N1M0 squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx between 2004 and 2012 who were treated with surgery with negative margins and no extracapsular extension. Logistic regression was used to assess predictors of receipt of postoperative treatment. Overall survival was assessed by the Kaplan-Meier method, and Cox regression analysis identified covariates that affected it. Results There were 1598 patients included in this study: 566 (35.4%) received surgery alone; 726 (45.4%), S + RT; and 306 (19.1%), S + CRT. The 5-year overall survival was 68.8%, 74.0%, and 87.8%, respectively ( P = .009 comparing S + RT and surgery alone, P < .001 for all other comparisons). On multivariable logistic regression, academic centers were associated with a decreased likelihood of S + RT (odds ratio = 0.71) and S + CRT (odds ratio = 0.66). Multivariable Cox regression demonstrated no difference in survival for S + RT over surgery alone (hazard ratio = 0.88, 95% CI = 0.70-1.09, P = .24); however, there was a survival benefit associated with S + CRT (hazard ratio = 0.57, 95% CI = 0.39-0.81, P = .002). Conclusion Nearly 65% of patients with pT1-2N1 head and neck cancer with negative margins and no extracapsular extension received S + RT or S + CRT. Improvement in survival was noted only for patients who received S + CRT.

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