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Nomogram of Tanvetyanon et al for Predicting Survival in a Patient Undergoing Reirradiation for a Head and Neck Cancer Arising in a Previously Irradiated Site

Description

Tanvetyanon et al developed a nomogram for predicting 2 year survival for a patient undergoing reirradiation of a cancer arising in a previously irradiated site in the head and neck. The authors are from the H. Lee Moffitt Cancer Center in Tampa, Florida.


 

Patient selection: new or recurrent carcinoma arising in a previously irradiated site

 

Parameters:

(1) presence of significant comorbidity (based on the Charlson comoribidity index)

(2) presence of organ dysfunction (requires feeding tube, functioning tracheostomy, fistula, osteonecrosis, soft tissue defect, etc)

(3) isolated recurrence in the neck

(4) tumor bulk in cm

(5) time interval in months between completion of previous radiation course and starting of new course

 

tumor bulk in cm =

= (maximum dimension of mucosal lesion) + (maximum dimension of tumor in the neck)

Parameter

Finding

Points

comorbidity

absent

0

 

present

30

organ dysfunction

absent

0

 

present

32.6

neck recurrence

isolated (no mucosal lesion)

0

 

not isolated (mucosal lesion present)

54.5

tumor bulk

 

5.75 * (bulk in cm)

time interval in months

 

100 - (0.1818 * (months))

 

total score =

= SUM(points for all 5 parameters)

 

Total Score

Probability of Surviving 2 Years

< 112

> 90%

112 to 146.5

(-0.00892 * ((points)^2)) + (1.723 * (points)) + 8.828

146.5 to 198.6

244 - (1.182 * (points))

> 198.6

< 10%

 


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