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[Evaluation of a predictive score for malnutrition in patients treated by irradiation for head and neck cancer: a retrospective study in 127 patients].

AbstractPURPOSE:
The purpose of this study was to establish a pre-therapeutic score that could predict which patients would be at high risk of enteral tube feeding during (chemo)-radiotherapy for head and neck cancer.
PATIENTS AND METHODS:
A monocentric study was conducted retrospectively on patients receiving a radiotherapy or concurrent chemoradiotherapy for a head and neck cancer. A logistic model was performed in order to assess clinical or therapeutic risk factors for required artificial nutrition during treatment. Significant parameters, issued from multivariate analysis, were summed and weighted in a score aiming at estimating a malnutrition risk during radiotherapy.
RESULTS:
Among the 127 evaluated patients, 59 patients required artificial nutrition during radiotherapy. In multivariate analysis, predictive factors for malnutrition were weight loss superior to 5% in the 3 months before radiotherapy, advanced tumor stage (III-IV vs. I-II), and pain requiring strong analgesics (step II-III vs. I). Concurrent chemotherapy was identified as a significant risk factor also, but it was strongly correlated with the tumor stage. The score, estimated from these previous factors, allowed a prediction of a risk of enteral feeding with a sensitivity of 90% and a specificity of 85%.
CONCLUSION:
A predictive score of enteral nutrition before radiotherapy of head and neck cancer should be a useful clinical tool to target the patients who would need a prophylactic gastrostomy. Our study evidenced some risk factors of malnutrition requiring artificial feeding. However, we need a prospective study to confirm the validity of this score.
AuthorsN Lescut, E Personeni, M Desmarets, M Puyraveau, R Hamlaoui, S Servagi-Vernat, J-F Bosset, F Nguyen
JournalCancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique (Cancer Radiother) Vol. 17 Issue 7 Pg. 649-55 (Nov 2013) ISSN: 1769-6658 [Electronic] France
Vernacular TitleÉvaluation d'un score prédictif de dénutrition chez les patients pris en charge par irradiation pour un cancer des voies aérodigestives supérieures : étude rétrospective chez 127 patients.
PMID24183935 (Publication Type: English Abstract, Journal Article)
CopyrightCopyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.
Chemical References
  • Analgesics, Opioid
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Albuminuria (epidemiology)
  • Analgesics, Opioid (therapeutic use)
  • Chemoradiotherapy
  • Female
  • Gastrostomy
  • Head and Neck Neoplasms (pathology, therapy)
  • Humans
  • Logistic Models
  • Male
  • Malnutrition (etiology, prevention & control)
  • Middle Aged
  • Neoplasm Staging
  • Nutritional Support
  • Pain (drug therapy)
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Weight Loss
  • Young Adult

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