Revalidation of Proactive Gastrostomy Tube Placement Guidelines for Head and Neck Cancer Patients Receiving Helical Intensity-Modulated Radiotherapy
The Royal Brisbane and Women’s Hospital (RBWH) Swallowing and Nutrition Management Guidelines for Patients with Head and Neck Cancer were developed to enable evidence-based decision-making by the Head and Neck Multidisciplinary Team (H&N MDT) regarding enteral nutrition support options. The purp...
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MDPI AG
2024-11-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/31/11/512 |
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| author | Teresa E. Brown Angela Byrnes Aaron C. Chan Kathleen Dwyer Anna Edwards Claire L. Blake Merrilyn D. Banks Brett G. M. Hughes Charles Y. Lin Lizbeth M. Kenny Ann-Louise Spurgin Judith D. Bauer |
| author_facet | Teresa E. Brown Angela Byrnes Aaron C. Chan Kathleen Dwyer Anna Edwards Claire L. Blake Merrilyn D. Banks Brett G. M. Hughes Charles Y. Lin Lizbeth M. Kenny Ann-Louise Spurgin Judith D. Bauer |
| author_sort | Teresa E. Brown |
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| description | The Royal Brisbane and Women’s Hospital (RBWH) Swallowing and Nutrition Management Guidelines for Patients with Head and Neck Cancer were developed to enable evidence-based decision-making by the Head and Neck Multidisciplinary Team (H&N MDT) regarding enteral nutrition support options. The purpose of this study was to revalidate these guidelines in a cohort of patients receiving helical intensity-modulated radiotherapy (H-IMRT) compared to a historical cohort who received primarily 3D-conformal radiotherapy. Eligible patients attending the RBWH H&N MDT between 2013 and 2014 (n = 315) were assessed by the guidelines, with high-risk patients being recommended proactive gastrostomy tube placement. Data were collected on guideline adherence, gastrostomy tube insertions, the duration of enteral tube use and weight change. Sensitivity, specificity and positive predictive and negative predictive values were calculated and compared with the historical cohort. Overall guideline adherence was 84%, with 60% and 96% adherence to the high-risk and low-risk pathways, respectively. Seventy patients underwent proactive gastrostomy tube placement (n = 62 high-risk; n = 8 low-risk). Validation outcomes were sensitivity 73% (compared to 72%) and specificity 86% (compared to 96%). The guidelines yielded a high sensitivity and specificity, remaining valid in a cohort of patients treated with H-IMRT. Further studies are recommended to improve the sensitivity and understand the decrease in specificity in order to make ongoing guideline improvements. |
| format | Article |
| id | doaj-art-2c07a0563fa94faf8d20ad5d1389109c |
| institution | OA Journals |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-2c07a0563fa94faf8d20ad5d1389109c2025-08-20T02:08:14ZengMDPI AGCurrent Oncology1198-00521718-77292024-11-0131116938695510.3390/curroncol31110512Revalidation of Proactive Gastrostomy Tube Placement Guidelines for Head and Neck Cancer Patients Receiving Helical Intensity-Modulated RadiotherapyTeresa E. Brown0Angela Byrnes1Aaron C. Chan2Kathleen Dwyer3Anna Edwards4Claire L. Blake5Merrilyn D. Banks6Brett G. M. Hughes7Charles Y. Lin8Lizbeth M. Kenny9Ann-Louise Spurgin10Judith D. Bauer11Dietetics & Food Services, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, AustraliaDietetics & Food Services, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, AustraliaSchool of Human Movement & Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, AustraliaNutrition & Food Services, Ipswich Hospital, Ipswich, QLD 4305, AustraliaSchool of Human Movement & Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, AustraliaDietetics & Food Services, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, AustraliaDietetics & Food Services, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, AustraliaCancer Care Services, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, AustraliaCancer Care Services, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, AustraliaCancer Care Services, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, AustraliaDepartment of Speech Pathology, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, AustraliaSchool of Human Movement & Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, AustraliaThe Royal Brisbane and Women’s Hospital (RBWH) Swallowing and Nutrition Management Guidelines for Patients with Head and Neck Cancer were developed to enable evidence-based decision-making by the Head and Neck Multidisciplinary Team (H&N MDT) regarding enteral nutrition support options. The purpose of this study was to revalidate these guidelines in a cohort of patients receiving helical intensity-modulated radiotherapy (H-IMRT) compared to a historical cohort who received primarily 3D-conformal radiotherapy. Eligible patients attending the RBWH H&N MDT between 2013 and 2014 (n = 315) were assessed by the guidelines, with high-risk patients being recommended proactive gastrostomy tube placement. Data were collected on guideline adherence, gastrostomy tube insertions, the duration of enteral tube use and weight change. Sensitivity, specificity and positive predictive and negative predictive values were calculated and compared with the historical cohort. Overall guideline adherence was 84%, with 60% and 96% adherence to the high-risk and low-risk pathways, respectively. Seventy patients underwent proactive gastrostomy tube placement (n = 62 high-risk; n = 8 low-risk). Validation outcomes were sensitivity 73% (compared to 72%) and specificity 86% (compared to 96%). The guidelines yielded a high sensitivity and specificity, remaining valid in a cohort of patients treated with H-IMRT. Further studies are recommended to improve the sensitivity and understand the decrease in specificity in order to make ongoing guideline improvements.https://www.mdpi.com/1718-7729/31/11/512head and neck cancerradiotherapygastrostomyenteral feedingnutrition |
| spellingShingle | Teresa E. Brown Angela Byrnes Aaron C. Chan Kathleen Dwyer Anna Edwards Claire L. Blake Merrilyn D. Banks Brett G. M. Hughes Charles Y. Lin Lizbeth M. Kenny Ann-Louise Spurgin Judith D. Bauer Revalidation of Proactive Gastrostomy Tube Placement Guidelines for Head and Neck Cancer Patients Receiving Helical Intensity-Modulated Radiotherapy Current Oncology head and neck cancer radiotherapy gastrostomy enteral feeding nutrition |
| title | Revalidation of Proactive Gastrostomy Tube Placement Guidelines for Head and Neck Cancer Patients Receiving Helical Intensity-Modulated Radiotherapy |
| title_full | Revalidation of Proactive Gastrostomy Tube Placement Guidelines for Head and Neck Cancer Patients Receiving Helical Intensity-Modulated Radiotherapy |
| title_fullStr | Revalidation of Proactive Gastrostomy Tube Placement Guidelines for Head and Neck Cancer Patients Receiving Helical Intensity-Modulated Radiotherapy |
| title_full_unstemmed | Revalidation of Proactive Gastrostomy Tube Placement Guidelines for Head and Neck Cancer Patients Receiving Helical Intensity-Modulated Radiotherapy |
| title_short | Revalidation of Proactive Gastrostomy Tube Placement Guidelines for Head and Neck Cancer Patients Receiving Helical Intensity-Modulated Radiotherapy |
| title_sort | revalidation of proactive gastrostomy tube placement guidelines for head and neck cancer patients receiving helical intensity modulated radiotherapy |
| topic | head and neck cancer radiotherapy gastrostomy enteral feeding nutrition |
| url | https://www.mdpi.com/1718-7729/31/11/512 |
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