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The "rocky treatment course": identifying a high-risk subgroup of head and neck cancer patients for supportive
Horia Vulpe1, Janet Ellis2, Shao Hui Huang1
1Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
Purpose:
We aim to identify the risk factors for a "rocky" treatment course (RTC) in head and neck cancer.
Methods:
A retrospective case-control study was conducted utilizing data from a prospective study. We defined the RTC as a composite of adverse outcomes including G-tube dependence and increased nursing interventions. Statistically associative variables were included in a multivariable logistic regression. We also evaluated whether the RTC, or its components, associated with worse cancer outcomes.
Results:
Being single, unemployed, having N2/3 disease and receiving chemoradiotherapy were associated with a RTC. In turn, G-tube dependence was associated with worse 3-year OS (73 vs 91 %; p = 0.02) and increased nursing interventions with worse 3-year locoregional recurrence-free survival (LRFS) (85 vs 92 %; p = 0.03) and locoregional recurrence (LRR) (14 vs 7 %; p = 0.03).
Conclusions:
We identified baseline factors associated with a RTC for head and neck cancer patients. Future supportive care interventions could be evaluated using the RTC as a marker of benefit.
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