Nomogram to predict risk of early mortality following definitive or adjuvant radiation and systemic therapy for head and neck cancer Journal Article
| Authors: | Raab, G.; Yu, Y.; Sherman, E.; Wong, R.; Mell, L. K.; Lee, N. Y.; Zakeri, K. |
| Article Title: | Nomogram to predict risk of early mortality following definitive or adjuvant radiation and systemic therapy for head and neck cancer |
| Abstract: | Purpose/Objectives: We sought to create nomograms to predict individual risk of early mortality, which can identify patients who require interventions to prevent early death. Methods: We included patients in the National Cancer Database with non-metastatic squamous cell carcinoma of the head and neck who received radiation and systemic therapy between 2004 and 2017 in the definitive or adjuvant setting. Early mortality was defined as any death less than 90 days after starting radiation. Multivariable logistic regression was used to assess the relationship between covariates and early mortality. Nomograms to predict the risk of early death were created for both the definitive and adjuvant settings. Results: Among 84,563 patients in the definitive group and 18,514 patients in the adjuvant group, rates of early mortality were 3.5 % (95 % CI 3.4–3.7 %) and 2.2 %, (95 % CI 1.9–2.4 %), respectively. Patients above the age of 70 had an early mortality rate of 7.8 % (95 % CI 7.3–8.2 %) in the definitive group and 4.4 % (95 % CI 3.6–5.4 %) in the adjuvant group. In the multivariable analysis, age, comorbidity, T and N category, and tumor site were associated with early mortality in both cohorts (p < 0.05 for all). Nomograms including age, comorbidity, T and N category and tumor site performed better than age alone at predicting early mortality (AUC for definitive group: 0.70 vs 0.66; AUC for adjuvant group: 0.71 vs 0.61). Conclusion: Nomograms including age, comorbidity, T and N category and tumor site were developed to predict the risk of early death following definitive or adjuvant chemoradiation. © 2024 The Authors |
| Keywords: | adult; human tissue; aged; major clinical study; area under the curve; systemic therapy; chemotherapy; follow up; radiation; palliative therapy; cohort analysis; cetuximab; histology; medicaid; medicare; death; education; head and neck cancer; cerebrovascular disease; heart infarction; peripheral vascular disease; diabetes mellitus; dementia; comorbidity; insurance; multivariate logistic regression analysis; liver disease; radiation therapy; univariate analysis; adjuvant radiotherapy; congestive heart failure; nomogram; chemoradiotherapy; income; race; mouth cavity; hemiplegia; head and neck squamous cell carcinoma; bootstrapping; peptic ulcer; mortality rate; paraplegia; charlson comorbidity index; human; male; female; article; larynx squamous cell carcinoma; hypopharynx squamous cell carcinoma; oropharynx squamous cell carcinoma; early mortality |
| Journal Title: | Clinical and Translational Radiation Oncology |
| Volume: | 45 |
| ISSN: | 2405-6308 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2024-03-01 |
| Start Page: | 100725 |
| Language: | English |
| DOI: | 10.1016/j.ctro.2024.100725 |
| PROVIDER: | scopus |
| PMCID: | PMC10832379 |
| PUBMED: | 38304239 |
| DOI/URL: | |
| Notes: | Article -- MSK corresponding author is Kaveh Zakeri -- Source: Scopus |
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