Functional outcomes of chemoradiation in patients with head and neck cancer

• Published in: Otolaryngology-head and neck surgery Vol. 148; no. 1; p. 64
• Main Authors: Tulunay-Ugur, Ozlem E, McClinton, Christopher, Young, Zachary, Penagaricano, Jose A, Maddox, Anne-Marie, Vural, Emre
• Format: Journal Article
• Language: English
• Published: England 01.01.2013
• Subjects: Cancer Care Facilities; Chemoradiotherapy - adverse effects; Chemoradiotherapy - methods; Cohort Studies; Enteral Nutrition - methods; Female; Follow-Up Studies; Gastrostomy - statistics & numerical data; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Head and Neck Neoplasms - therapy; Humans; Hypopharyngeal Neoplasms - mortality; Hypopharyngeal Neoplasms - pathology; Hypopharyngeal Neoplasms - surgery; Hypopharyngeal Neoplasms - therapy; Male; Neck Dissection - adverse effects; Neck Dissection - methods; Oropharyngeal Neoplasms - mortality; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - surgery; Oropharyngeal Neoplasms - therapy; Quality of Life; Recovery of Function; Retrospective Studies; Risk Assessment; Survival Analysis; Time Factors; Tracheotomy - statistics & numerical data; Treatment Outcome
• ISSN: 1097-6817
• DOI: 10.1177/0194599812459325

Concurrent chemoradiotherapy (CCRT) has become the treatment of choice for oropharyngeal and hypopharyngolaryngeal cancers in many centers. Although it has increased the rates of organ preservation, there has also been an increase in treatment-related complications. We aimed to evaluate the functional outcomes of CCRT in head and neck cancer. Case series with chart review. Tertiary cancer center. A retrospective study of patients treated with CCRT at the University of Arkansas for Medical Sciences was performed. Demographic data and treatment outcomes were extracted, specifically feeding tube and tracheotomy dependence and number of esophageal dilatations. Of the 243 patients treated with concurrent chemoradiotherapy (5-fluorouracil + cysplatin and radiotherapy), 152 patients received a feeding tube. The median percutaneous gastrostomy tube (PEG) use was 9 months (range, 1-96 months). More than 70% of the patients who had a PEG more than 6 months had a T3 or T4 tumor. Thirty-seven patients underwent esophageal dilatations, (median, 1; range, 1-7). The median use of a tracheotomy was 7 months, and 77% of these patients were treated for hypopharyngolaryngeal cancer. Despite major improvement in locoregional control rates, CCRT has a significant negative impact on the functional outcomes of head and neck cancer patients, with a high number of patients remaining PEG and tracheotomy dependent.