The "rocky treatment course": identifying a high-risk subgroup of head and neck cancer patients for supportive interventions.

Abstract

We aim to identify the risk factors for a "rocky" treatment course (RTC) in head and neck cancer. 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. 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). 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.