TY - JOUR
T1 - Development and validation of a prediction model for tube feeding dependence after curative (chemo-) radiation in head and neck cancer
AU - Wopken, Kim
AU - Bijl, Hendrik P.
AU - van der Schaaf, Arjen
AU - Christianen, Miranda E.
AU - Chouvalova, Olga
AU - Oosting, Sjoukje F.
AU - van der Laan, Bernard F. A. M.
AU - Roodenburg, Jan L. N.
AU - Leemans, C. Rene
AU - Slotman, Ben J.
AU - Doornaert, Patricia
AU - Steenbakkers, Roel J. H. M.
AU - Verdonck-de Leeuw, Irma M.
AU - Langendijk, Johannes A.
PY - 2014/4/15
Y1 - 2014/4/15
N2 - Background: Curative radiotherapy or chemoradiation for head and neck cancer (HNC) may result in severe acute and late side effects, including tube feeding dependence. The purpose of this prospective cohort study was to develop a prediction model for tube feeding dependence 6 months (TUBEM6) after curative (chemo-) radiotherapy in HNC patients.Patients and Methods: Tube feeding dependence was scored prospectively. To develop the multivariable model, a group LASSO analysis was carried out, with TUBEM6 as the primary endpoint (n = 427). The model was then validated in a test cohort (n = 183). The training cohort was divided into three groups based on the risk of TUBEM6 to test whether the model could be extrapolated to later time points (12, 18 and 24 months).Results: Most important predictors for TUBEM6 were weight loss prior to treatment, advanced T-stage, positive N-stage, bilateral neck irradiation, accelerated radiotherapy and chemoradiation. Model performance was good, with an Area under the Curve of 0.86 in the training cohort and 0.82 in the test cohort. The TUBEM6-based risk groups were significantly associated with tube feeding dependence at later time points (pConclusion: We established an externally validated predictive model for tube feeding dependence after curative radiotherapy or chemoradiation, which can be used to predict TUBEM6.
AB - Background: Curative radiotherapy or chemoradiation for head and neck cancer (HNC) may result in severe acute and late side effects, including tube feeding dependence. The purpose of this prospective cohort study was to develop a prediction model for tube feeding dependence 6 months (TUBEM6) after curative (chemo-) radiotherapy in HNC patients.Patients and Methods: Tube feeding dependence was scored prospectively. To develop the multivariable model, a group LASSO analysis was carried out, with TUBEM6 as the primary endpoint (n = 427). The model was then validated in a test cohort (n = 183). The training cohort was divided into three groups based on the risk of TUBEM6 to test whether the model could be extrapolated to later time points (12, 18 and 24 months).Results: Most important predictors for TUBEM6 were weight loss prior to treatment, advanced T-stage, positive N-stage, bilateral neck irradiation, accelerated radiotherapy and chemoradiation. Model performance was good, with an Area under the Curve of 0.86 in the training cohort and 0.82 in the test cohort. The TUBEM6-based risk groups were significantly associated with tube feeding dependence at later time points (pConclusion: We established an externally validated predictive model for tube feeding dependence after curative radiotherapy or chemoradiation, which can be used to predict TUBEM6.
KW - QUALITY-OF-LIFE
KW - ACCELERATED RADIOTHERAPY
KW - SWALLOWING DYSFUNCTION
KW - RANDOMIZED-TRIAL
KW - CHEMOTHERAPY
KW - CARCINOMA
KW - DYSPHAGIA
KW - IMPACT
KW - CHEMORADIOTHERAPY
KW - CHEMORADIATION
U2 - 10.1371/journal.pone.0094879
DO - 10.1371/journal.pone.0094879
M3 - Article
C2 - 24736318
SN - 1932-6203
VL - 9
JO - PLoS ONE
JF - PLoS ONE
IS - 4
M1 - e94879
ER -