Definitive IMRT Associated With Shorter Feeding Tube Placement Duration in HNC
A patient receiving radiotherapy.
Patients with head and neck cancer treated with intensity-modulated radiation therapy (IMRT) had a significantly shorter duration of feeding tube placement compared with those who received 3-dimensional radiation treatment (3DRT), according to a study published in the journal Cancer.1
During the course of RT, patients who develop significant adverse events and are at risk for malnutrition are often referred for placement of a feeding tube, which provides an alternative pathway for nutrition and medication administration that bypasses the areas affected by the local symptoms.
IMRT is a technologically advanced and resource-intensive method of administering RT and is used to minimize the risk for developing toxicities in patients with head and neck cancer; however, the incidence of placement and duration of feeding tube use among patients treated with IMRT remains unclear.
For the study, investigators analyzed data from 2993 patients with head and neck included in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Of those, 54.4% had had a feeding tube placed during a median follow-up of nearly 4 years.
Results showed that the median duration from feeding tube placement to removal was 277 days. The rates of feeding tube placement were similar between patients treated with IMRT and those who received 3DRT (P =.35), but patients treated with 3DRT had a feeding nearly 20% longer than those who received IMRT (P =.03).
Duration of feeding tube placement was only significantly different among patients who received definitive RT. Investigators observed no significant difference in feeding tube placement or duration among patients who underwent surgery and received adjuvant RT.
The findings ultimately suggest that IMRT may be associated with significant quality of life benefits with respect to long-term swallowing function in this patient population.
1. Beadle BM, Liao KP, Giordano SH, et al. Reduced feeding tube duration with intensity-modulated radiation therapy for head and neck cancer: a Surveillance, Epidemiology, and End Results-Medicare analysis. Cancer. 2016 Sep 23. doi: 10.1002/cncr.30350. [Epub ahead of print]