Sarcopenia, a strong determinant for prolonged feeding tube dependency after chemoradiotherapy for head and neck cancer

Head Neck. 2019 Nov;41(11):4000-4008. doi: 10.1002/hed.25938. Epub 2019 Aug 31.

Abstract

Background: Sarcopenia might be a relevant lead for optimization of the condition of patients with head and neck cancer (HNC) before chemoradiotherapy (CRT) to prevent long-term functional swallowing impairment, such as feeding tube dependency.

Methods: Regression analyses were performed to assess the association between skeletal muscle mass index (SMI), as a measure of sarcopenia, and prolonged (>90 days) feeding tube dependency in 128 patients with HNC treated with primary CRT.

Results: Sixty-one patients (48%) became prolonged feeding tube-dependent. Lower SMI increased the risk of prolonged feeding tube dependency in multivariable analysis (risk ratio 1.08; 95% confidence interval 1.02-1.14, P = .01) adjusted for body mass index, abnormal diet, and socioeconomic status.

Conclusions: Sarcopenia contributes to the risk of prolonged feeding tube dependency of patients with HNC treated with primary CRT. As sarcopenia might be a modifiable factor prior to treatment, it should be explored as a target for pretreatment patients' condition.

Keywords: chemoradiotherapy; head and neck cancer; sarcopenia; skeletal muscle mass; tube feeding.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chemoradiotherapy*
  • Enteral Nutrition*
  • Female
  • Head and Neck Neoplasms / complications*
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Intubation, Gastrointestinal*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Sarcopenia / complications*
  • Social Class

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