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Sub-category:
Head and Neck Cancer
Category:
Head and Neck Cancer
Meeting:
2003 ASCO Annual Meeting
Session Type and Session Title:
Poster Discussion, Head and Neck Cancer
Abstract No:
2004
Citation:
Proc Am Soc Clin Oncol 22: 2003 (abstr 2004)
Author(s):
M. A. List, D. Haraf, R. Egan, P. Bilir, B. Mittal, A. Argiris, F. Rosen, K. Stenson, J. Dignam, E. E. Vokes; University of Chicago, Chicago, IL; Northwestern Memorial Hospital, Chicago, IL; University of Illinois at Chicago, Chicago, IL
Abstract:
This paper examines factors associated with 12-month non-oral feeding (NPO) in advanced stage HNC patients post concurrent chemoradiotherapy (CRT). While these regimens appear successful in improving disease control and survival as well as function/quality of life (QOL), data also document significant long-term dysfunction in at least a subgroup of patients. Of particular concern are those who remain feeding tube dependent upwards of a year post treatment. Prospective QOL/functional data were collected on 251 patients treated on one of four sequential CRT trials conducted across four Chicago institutions (I-IV). Trials 1 & 2 (Group A) included five cycles of twice daily radiation with concurrent CRT (5-FU, hydroxyurea and paclitaxel). Trials 3 & 4 (Group B) added two cycles of induction chemotherapy to the above regimen. Pre-treatment QOL/functional data and 12-month diet data were available on 172 of 210 patients alive at 12 months. In spite of the addition of induction chemotherapy only 6% of patients in Group B were unable to take anything by mouth at 12 months compared to 19% of patients in Group A. By univariate analyses other pre-treatment variables associated with increased risk (p<.05) of NPO status at 12 months included: larger tumor, feeding tube, restricted diet, difficulty being understood, sticky saliva, hoarseness, poorer overall performance status, decreased head & neck well being (FACT subscale), African American race, lower income and institution I. Group remained significant in multivariate analyses controlling for all other variables. While further investigation is warranted, differences in CRT regimens, increased use of sophisticated radiation techniques, changes in supportive care, and more proactive swallowing intervention may have contributed to improvement in long term eating ability. In conclusion, the decline in the number of patients with severe oral dysfunction to only 6% supports the continued development of aggressive regimens focusing on survival.
 Associated Presentation(s):
Other Abstracts in this Sub-Category:
Abstracts by M. A. List:
Presentations by M. A. List:
Educational Book Manuscripts by M. A. List:
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