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.

scholarly journals Prospective Studies of Body Mass Index with Head and Neck Cancer Incidence and Mortality

2012 ◽  
Vol 21 (3) ◽  
pp. 497-503 ◽  
Author(s):  
Mia M. Gaudet ◽  
Alpa V. Patel ◽  
Juzhong Sun ◽  
Janet S. Hildebrand ◽  
Marjorie L. McCullough ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Body Mass ◽  
Neck Cancer ◽  
Cancer Incidence ◽  
Prospective Studies ◽  
Incidence And Mortality

scholarly journals Predictors of Survival After Head and Neck Cancer in South America: Preliminary Results of the InterCHANGE Study

2018 ◽  
Vol 4 (Supplement 1) ◽  
pp. 24s-24s
Author(s):  
Renata Abrahao ◽  
Sandra Perdomo ◽  
Luis Kowalski ◽  
Marta Vilensky ◽  
Jose Carlos Oliveira ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Head And Neck Cancer ◽  
South America ◽  
Oral Cavity ◽  
Head And Neck ◽  
Body Mass ◽  
Neck Cancer ◽  
Stage At Diagnosis ◽  
Hpv16 E6 ◽  
Oropharynx Cancer

Abstract 65 Purpose Incidence of head and neck cancer (HNC) is high in South America, and survival data are scarce in this region. The InterCHANGE study was established by clinical groups from across South America and the International Agency for Research on Cancer, with the primary aim to study the impact of human papillomavirus (HPV) infection and sociodemographic, clinic, and lifestyle factors on survival after this malignancy. The current study examined the main predictors of survival after HNC in South America and estimated overall and conditional survival probabilities. Methods Patients were recruited during 2010 to 2016 from seven centers in Argentina, Brazil, Colombia, and Uruguay. A questionnaire obtained information on age, stage, and body mass index at diagnosis; sex; education; race; and comprehensive smoking and alcohol history. Blood samples were collected for HPV16 E6 testing—a surrogate marker for HPV16 infection. The Kaplan-Meier method and Cox proportional hazards regression were used for statistical analyses. Results Of 1,314 patients, 348 had oropharynx cancer and 966 nonoropharynx cancer (larynx, n = 381; hypopharynx, n = 75; and oral cavity, n = 510). All cases were confirmed by histology or cytology. Most patients were male (81%), of white race (64%), ever smokers (85%), ever drinkers (82%), had a median age at diagnosis of 60 years, and only a basic education (54%). The majority of patients (66%) was diagnosed with stage IV disease, ranging from 53% for larynx to 83% for oropharynx disease. Median follow-up time for patients who died or survived was 0.9 years of 2.3 years, respectively. By October 31, 2017, 628 patients (48%) had died. Three-year overall survival was 53% for larynx, 47% for oral cavity, 40% for oropharynx, and 36% for hypopharynx disease. Main predictors of worse survival were late stage at diagnosis, older age, and underweight (body mass index < 18.5kg/m2) at diagnosis, with some variation according to tumor site. In a subset analysis of 156 patients with oropharynx cancer with available HPV16 E6 serology, those who were negative for HPV16 E6 had significantly lower 3-year survival (27% v 73%), and a corresponding 3.5 times higher mortality rate (adjusted hazard ratio, 3.5; CI, 1.2 to 10.6) than those who were positive for HPV16 E6. Conclusion Most patients presented with strikingly advanced disease, and stage at diagnosis was an important predictor of survival. The reasons for late diagnosis are unclear, and efforts to improve survival will largely depend on efforts to diagnose HNC at an early stage. Patients with HPV-related versus HPV-unrelated oropharynx cancer had better survival, which supports previous results from Europe and North America. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

Evolution of self‐perceived swallowing function, tongue strength and swallow‐related quality of life during radiotherapy in head and neck cancer patients

Head & Neck ◽  
2019 ◽  
Vol 41 (7) ◽  
pp. 2197-2207 ◽  
Author(s):  
Leen Van den Steen ◽  
Dirk Van Gestel ◽  
Olivier Vanderveken ◽  
Jan Vanderwegen ◽  
Cathy Lazarus ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Tongue Strength ◽  
Swallowing Function ◽  
Related Quality

Weight loss and body mass index in relation to aspiration in patients treated for head and neck cancer: a long-term follow-up

2014 ◽  
Vol 22 (9) ◽  
pp. 2361-2369 ◽  
Author(s):  
Sandra Ottosson ◽  
Ulrika Lindblom ◽  
Peter Wahlberg ◽  
Per Nilsson ◽  
Elisabeth Kjellén ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Body Mass ◽  
Neck Cancer ◽  
Long Term Follow Up
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