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Session Item

Epidemiology and prevention

Session Type: Poster

Journey:

Early non-cancer mortality risk prediction after definitive radiotherapy in Head and Neck Cancer

Kristian Hastoft Jensen, Denmark

Presentation Number: PO-0055

Abstract

Abstract Title:

Early non-cancer mortality risk prediction after definitive radiotherapy in Head and Neck Cancer

Authors:

Kristian Hastoft Jensen¹, Ivan Richter Vogelius¹, Claus Andrup Kristensen¹, Christian Maare², Elo Andersen², Lena Specht¹, Anita Gothelf¹, Mogens Bernsdorf³, Jeppe Friborg¹

¹Copenhagen University Hospital, Rigshospitalet, Department of Oncology, Copenhagen, Denmark; ²Copenhagen University Hospital, Herlev, Department of Oncology, Herlev, Denmark; ³Copenhagen University Hospital, Rigshospitalet, Department of Oncology, Rigshospitalet, Denmark

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Purpose or Objective

In patients with head and neck squamous cell carcinoma (HNSCC), curative-intent radiotherapy (RT) and chemoradiotherapy (CRT) are associated with substantial acute morbidity and 5–10% of patients die within 180 days of treatment initiation. Most of these early deaths occur without HNSCC recurrence or progression and may therefore be preventable to some extent. We developed a prediction tool to estimate the risk of non-HNSCC mortality occurring within the first 180 days following RT/CRT initiation.

Material and Methods

Patients with HNSCC treated with RT/CRT, including postoperative RT/CRT, at Rigshospitalet or Herlev Hospitals between 2010–2017 were identified in the Danish Head and Neck Cancer Group (DAHANCA) database. Predictor variables included age, stage, performance status, tumor subsite including p16 status, comorbidity, postoperative status, smoking and pre-treatment albumin levels. The 180-day non-HNSCC mortality risk was estimated by combining cause-specific Cox regression models.

Results

We included 2209 patients. The 180-day non-HNSCC mortality rate was 4.4% and almost one third (31.6%) of non-HNSCC deaths were caused by pneumonia. After internal model validation, the area under the receiver operating curve was 0.74 (95% CI: 0.66–0.81) and calibration was good for risk predictions ranging from 0–20%.

Conclusion

We developed a prediction tool to estimate the 180-day non-HNSCC mortality risk. This tool can be used to select high-risk patients for supportive interventions aiming to improve survival rates, and is available for interactive use at https://emriskpred.shinyapps.io/EMNED_App/.