Development of a multivariable normal tissue complication probability (NTCP) model for tube feeding dependence after curative radiotherapy/chemo-radiotherapy in head and neck cancer

Kim Wopken*, Hendrik P. Bijl, Arjen van der Schaaf, Hans Paul van der Laan, Olga Chouvalova, Roel J. H. M. Steenbakkers, Patricia Doornaert, Ben J. Slotman, Sjoukje F. Oosting, Miranda E. M. C. Christianen, Bernard F. A. M. van der Laan, Jan L. N. Roodenburg, C. Rene Leemans, Irma M. Verdonck-de Leeuw, Johannes A. Langendijk

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background and purpose: Curative radiotherapy/chemo-radiotherapy 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 multivariable normal tissue complication probability (NTCP) model for tube feeding dependence 6 months (TUBEM6) after definitive radiotherapy, radiotherapy plus cetuximab or concurrent chemoradiation based on pre-treatment and treatment characteristics.

Materials and methods: The study included 355 patients with HNC. TUBEM6 was scored prospectively in a standard follow-up program. To design the prediction model, the penalized learning method LASSO was used, with TUBEM6 as the endpoint.

Results: The prevalence of TUBEM6 was 10.7%. The multivariable model with the best performance consisted of the variables: advanced T-stage, moderate to severe weight loss at baseline, accelerated radiotherapy, chemoradiation, radiotherapy plus cetuximab, the mean dose to the superior and inferior pharyngeal constrictor muscle, to the contralateral parotid gland and to the cricopharyngeal muscle.

Conclusions: We developed a multivariable NTCP model for TUBEM6 to identify patients at risk for tube feeding dependence. The dosimetric variables can be used to optimize radiotherapy treatment planning aiming at prevention of tube feeding dependence and to estimate the benefit of new radiation technologies. (C) 2014 The Authors. Published by Elsevier Ireland Ltd.

Original languageEnglish
Pages (from-to)95-101
Number of pages7
JournalRadiotherapy and Oncology
Volume113
Issue number1
DOIs
Publication statusPublished - Oct-2014

Keywords

  • Head and neck cancer
  • IMRT
  • (chemo-)radiotherapy
  • INTENSITY-MODULATED RADIOTHERAPY
  • SQUAMOUS-CELL CARCINOMA
  • PERCUTANEOUS ENDOSCOPIC GASTROSTOMY
  • LOCALLY-ADVANCED HEAD
  • SWALLOWING DYSFUNCTION
  • RADIATION-THERAPY
  • OROPHARYNGEAL CANCER
  • VOLUME PARAMETERS
  • REDUCE DYSPHAGIA
  • STICKY SALIVA

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