medical decision support medical decision support
Sign In

Predictive Enteral Grading (PEG) Score of Poulsen et al for Acute Grade 4 Swallowing Toxicity Following Radiotherapy Alone for Stage III or IV Squamous Cell Carcinoma of the Head and Neck

Description

Poulsen et al evaluated patients receiving radiotherapy alone for squamous cell carcinoma of the head and neck. They identified risk factors for acute severe swallowing toxicity. The authors are from Princess Alexandra Hospital and Royal Brisbane and Women's Hospital in Australia.


Patient selection: Stage III or IV squamous cell carcinoma of the head and neck treated with radiotherapy alone

 

Outcome: acute grade 4 swallowing toxicity (requiring IV or enteral feeding) at 168 days (6 month)

 

Parameters:

(1) craniocaudal length of boost field in mm

(2) substage grouping

(3) fractionation

(4) ECOG scale (from 0 to 4)

 

Substage Group

T and N Status

1

T1 or T2, N1

2

T3 N0

3

T1 or T2, N2; T4 N0; T3 or T4 N1

4

T1 or T2 N3; T3 or T4 N2 or N3

 

 

Parameter

Finding

Points

length of boost field

<= 82 mm

0

 

> 82 mm

3

substage group

T1 or T2, N1

0

 

other

1

fractionation

conventional

0

 

accelerated

2

ECOG

0 or 1

0

 

2 to 4

1

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 7

• The higher the score the greater the risk for acute grade 4 swallowing toxicity.

• A score < 6 was associated with 19% grade 4 swallowing toxicity versus 45% if 6 or 7.


To read more or access our algorithms and calculators, please log in or register.

Specialty