Matched pair analysis to evaluate the impact of hospitalization during radiation therapy as an early marker of survival in head and neck cancer patients.

Cancer specific survival Carcinoma Head and neck cancer Hospitalization Overall survival Radiotherapy Response to treatment SCC SCCHN Squamous cell

Journal

Oral oncology
ISSN: 1879-0593
Titre abrégé: Oral Oncol
Pays: England
ID NLM: 9709118

Informations de publication

Date de publication:
16 Jun 2020
Historique:
received: 28 02 2020
revised: 26 05 2020
accepted: 07 06 2020
pubmed: 20 6 2020
medline: 20 6 2020
entrez: 20 6 2020
Statut: aheadofprint

Résumé

Complications from radiotherapy (RT) alone or combined with surgery and/or chemotherapy for head and neck cancer (HNC) sometimes necessitate hospitalization. Our aim was to evaluate the frequency, cause, and survival outcomes associated with hospitalizations in patients undergoing RT for HNC. Using a retrospective single-institution database, we reviewed hospitalization records of HNC patients treated at Roswell Park Comprehensive Cancer Center with definitive or post-operative RT between 2003 and 2017. Patients who were admitted during treatment and within 90-days post-RT were identified. Multivariate analyses, Kaplan-Meier statistics, and analysis on propensity score matching were performed to obtain matched-pair, after matching baseline characteristics, such as age, gender, smoking, tumor staging, p16 status, and treatments received. 839 patients were eligible for analysis. Median follow-up was 34.8 months (Interquartile range [IQR] 15.6-64.8). 595 (71%) received definitive RT and 244 (29%) received adjuvant RT. Chemotherapy was used in 671 patients (80%). 171 patients (20%) had at least one hospitalization. Dehydration (40%) and fever (29%) were the most frequent causes of admission. Hospitalized patients had significantly worse overall survival (OS) (Hazards ratio [HR] 1.61, 95% CI 1.26-2.07, p < 0.001) and cancer-specific survival (CSS) (HR 1.45, 95% CI 1.07-1.95, p = 0.02). 163 matched pairs had median follow-up of 58.6 months (IQR 37.6-85.0). Median OS was 34.5 months (IQR 13.3-58.0) for hospitalized versus 44.2 months (IQR 20.3-78.7) for non-hospitalized patients (p = 0.01). This study reveals significantly worse OS and CSS for patients hospitalized during RT for HNC. Hospitalization may be an early marker for worse survival.

Sections du résumé

BACKGROUND BACKGROUND
Complications from radiotherapy (RT) alone or combined with surgery and/or chemotherapy for head and neck cancer (HNC) sometimes necessitate hospitalization. Our aim was to evaluate the frequency, cause, and survival outcomes associated with hospitalizations in patients undergoing RT for HNC.
PATIENTS AND METHODS METHODS
Using a retrospective single-institution database, we reviewed hospitalization records of HNC patients treated at Roswell Park Comprehensive Cancer Center with definitive or post-operative RT between 2003 and 2017. Patients who were admitted during treatment and within 90-days post-RT were identified. Multivariate analyses, Kaplan-Meier statistics, and analysis on propensity score matching were performed to obtain matched-pair, after matching baseline characteristics, such as age, gender, smoking, tumor staging, p16 status, and treatments received.
RESULTS RESULTS
839 patients were eligible for analysis. Median follow-up was 34.8 months (Interquartile range [IQR] 15.6-64.8). 595 (71%) received definitive RT and 244 (29%) received adjuvant RT. Chemotherapy was used in 671 patients (80%). 171 patients (20%) had at least one hospitalization. Dehydration (40%) and fever (29%) were the most frequent causes of admission. Hospitalized patients had significantly worse overall survival (OS) (Hazards ratio [HR] 1.61, 95% CI 1.26-2.07, p < 0.001) and cancer-specific survival (CSS) (HR 1.45, 95% CI 1.07-1.95, p = 0.02). 163 matched pairs had median follow-up of 58.6 months (IQR 37.6-85.0). Median OS was 34.5 months (IQR 13.3-58.0) for hospitalized versus 44.2 months (IQR 20.3-78.7) for non-hospitalized patients (p = 0.01).
CONCLUSION CONCLUSIONS
This study reveals significantly worse OS and CSS for patients hospitalized during RT for HNC. Hospitalization may be an early marker for worse survival.

Identifiants

DOI: 10.1016/j.oraloncology.2020.104854 PMID: 32559724 PMC: PMC7738364
pubmed: 32559724
pii: S1368-8375(20)30290-6
doi: 10.1016/j.oraloncology.2020.104854
pmc: PMC7738364
mid: NIHMS1604798
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104854

Subventions

Organisme : NCI NIH HHS
ID : P30 CA016056
Pays : United States

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Auteurs

Hye Ri Han (HR)

Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY 14203, USA. Electronic address: hyerihan@buffalo.edu.

Gregory M Hermann (GM)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Gregory.Hermann@RoswellPark.org.

Sung Jun Ma (SJ)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: SungJun.Ma@RoswellPark.org.

Austin J Iovoli (AJ)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Austin.Iovoli@RoswellPark.org.

Kimberly E Wooten (KE)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Kimberly.Wooten@RoswellPark.org.

Hassan Arshad (H)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Hassan.Arshad@RoswellPark.org.

Vishal Gupta (V)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Vishal.Gupta@RoswellPark.org.

Ryan P McSpadden (RP)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Ryan.McSpadden@RoswellPark.org.

Moni A Kuriakose (MA)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Moni.Kuriakose@RoswellPark.org.

Michael R Markiewicz (MR)

Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, The State University of New York, 3435 Main Street, Buffalo, NY 14214, USA; Department of Neurosurgery, Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY 14203, USA; Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Michael.Markiewicz@RoswellPark.org.

Jon M Chan (JM)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Jon.Chan@RoswellPark.org.

Mary E Platek (ME)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA; Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA; Department of Dietetics, D'Youville College, 270 Porter Avenue, Buffalo, NY 14201, USA. Electronic address: Mary.Platek@RoswellPark.org.

Andrew D Ray (AD)

Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Andrew.Ray@RoswellPark.org.

Fangyi Gu (F)

Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Fangyi.gu@RoswellPark.org.

Wesley L Hicks (WL)

Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Wesley.Hicks@RoswellPark.org.

Elizabeth A Repasky (EA)

Department of Immunology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Elizabeth.Repasky@RoswellPark.org.

Anurag K Singh (AK)

Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA. Electronic address: Anurag.Singh@RoswellPark.org.

Classifications MeSH