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% |
Specialty: Hematology Oncology, Surgery, general, Otolaryngology
