Factors associated with complex oral treatment device usage in patients with head and neck cancer

Stephen Palasi; Ning Zhang; Mikaela Bankston; Joy Godby; Hannah Burrows; Jennifer Lagunas; William Perkison; Brandon Gunn; Mark S. Chambers; David I. Rosenthal; William Morrison; Adam Garden; Clifton David Fuller; Sharon Giordano; Eugene J. Koay

doi:10.1016/j.ctro.2021.08.004

Factors associated with complex oral treatment device usage in patients with head and neck cancer

Stephen Palasi, Ning Zhang, Mikaela Bankston, Joy Godby, Hannah Burrows, Jennifer Lagunas, William Perkison, Brandon Gunn, Mark S. Chambers, David I. Rosenthal, William Morrison, Adam Garden, Clifton David Fuller, Sharon Giordano, Eugene J. Koay

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose: The objective was to identify clinical and epidemiological factors associated with utilization of a complex oral treatment device (COTD), which may decrease toxicity in patients undergoing radiation therapy for head and neck cancer (HNC).

Materials and Methods: We retrospectively reviewed data from 1992 to 2013 in the Surveillance, Epidemiology, and End Results (SEER)-Medicare databases to analyze COTD usage during intensity-modulated radiation therapy (IMRT) for patients diagnosed with cancer of the tongue, floor of mouth, nasopharynx, tonsil, or oropharynx. Patients with a radiation simulation and complex treatment device code within 4 weeks before the first IMRT claim were identified as meeting COTD usage criteria. Demographic, regional, tumor, and treatment data were analyzed.

Results: Out of 4511 patients who met eligibility criteria, 1932 patients (42.8%) did not utilize a COTD while 2579 (57.2%) met usage criteria. COTD utilization increased over time (36.36% usage in 1992 vs. 67.44% usage in 2013, p < .0001). Patients less likely to receive a COTD included those aged 86 years or older compared to those aged 66-70 (OR = 0.713, 95% CI: 0.528-0.962), male patients (OR = 0.817, 95% CI: 0.710-0.941), non-Hispanic Black patients compared to non-Hispanic White patients (OR = 0.750, 95% CI: 0.582-0.966), and Louisiana residents (OR = 0.367, 95% CI: 0.279-0.483). Cancer site, grade, stage, or function of IMRT had no significant association with COTD usage.

Conclusions: This study serves as the first known SEER-Medicare review of COTD utilization. Despite an increase in COTD usage over time, our results indicate age, gender, and geographic disparities are associated with utilization. Further research and development into methods that increase availability of COTDs may help increase utilization in specific patient populations.

Original language	English (US)
Pages (from-to)	78-83
Number of pages	6
Journal	Clinical and Translational Radiation Oncology
Volume	30
DOIs	https://doi.org/10.1016/j.ctro.2021.08.004
State	Published - Sep 2021

Keywords

Head and neck cancer
Oral mucositis
Radiation
SEER-Medicare
Stent

ASJC Scopus subject areas

Oncology
Radiology Nuclear Medicine and imaging

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10.1016/j.ctro.2021.08.004

Cite this

Palasi, S., Zhang, N., Bankston, M., Godby, J., Burrows, H., Lagunas, J., Perkison, W., Gunn, B., Chambers, M. S., Rosenthal, D. I., Morrison, W., Garden, A., Fuller, C. D., Giordano, S., & Koay, E. J. (2021). Factors associated with complex oral treatment device usage in patients with head and neck cancer. Clinical and Translational Radiation Oncology, 30, 78-83. https://doi.org/10.1016/j.ctro.2021.08.004

Palasi, S, Zhang, N, Bankston, M, Godby, J, Burrows, H, Lagunas, J, Perkison, W, Gunn, B, Chambers, MS, Rosenthal, DI, Morrison, W, Garden, A, Fuller, CD, Giordano, S & Koay, EJ 2021, 'Factors associated with complex oral treatment device usage in patients with head and neck cancer', Clinical and Translational Radiation Oncology, vol. 30, pp. 78-83. https://doi.org/10.1016/j.ctro.2021.08.004

@article{db89f71ff571498bad7828d627d7ea95,

title = "Factors associated with complex oral treatment device usage in patients with head and neck cancer",

abstract = "Purpose: The objective was to identify clinical and epidemiological factors associated with utilization of a complex oral treatment device (COTD), which may decrease toxicity in patients undergoing radiation therapy for head and neck cancer (HNC).Materials and Methods: We retrospectively reviewed data from 1992 to 2013 in the Surveillance, Epidemiology, and End Results (SEER)-Medicare databases to analyze COTD usage during intensity-modulated radiation therapy (IMRT) for patients diagnosed with cancer of the tongue, floor of mouth, nasopharynx, tonsil, or oropharynx. Patients with a radiation simulation and complex treatment device code within 4 weeks before the first IMRT claim were identified as meeting COTD usage criteria. Demographic, regional, tumor, and treatment data were analyzed.Results: Out of 4511 patients who met eligibility criteria, 1932 patients (42.8%) did not utilize a COTD while 2579 (57.2%) met usage criteria. COTD utilization increased over time (36.36% usage in 1992 vs. 67.44% usage in 2013, p < .0001). Patients less likely to receive a COTD included those aged 86 years or older compared to those aged 66-70 (OR = 0.713, 95% CI: 0.528-0.962), male patients (OR = 0.817, 95% CI: 0.710-0.941), non-Hispanic Black patients compared to non-Hispanic White patients (OR = 0.750, 95% CI: 0.582-0.966), and Louisiana residents (OR = 0.367, 95% CI: 0.279-0.483). Cancer site, grade, stage, or function of IMRT had no significant association with COTD usage. Conclusions: This study serves as the first known SEER-Medicare review of COTD utilization. Despite an increase in COTD usage over time, our results indicate age, gender, and geographic disparities are associated with utilization. Further research and development into methods that increase availability of COTDs may help increase utilization in specific patient populations.",

keywords = "Head and neck cancer, Oral mucositis, Radiation, SEER-Medicare, Stent",

author = "Stephen Palasi and Ning Zhang and Mikaela Bankston and Joy Godby and Hannah Burrows and Jennifer Lagunas and William Perkison and Brandon Gunn and Chambers, {Mark S.} and Rosenthal, {David I.} and William Morrison and Adam Garden and Fuller, {Clifton David} and Sharon Giordano and Koay, {Eugene J.}",

note = "Funding Information: This research was supported, in part, by CPRIT RP160674, Komen SAC150061 and P30 CA016672. Dr. Fuller received funding and salary support from: the National Institutes of Health (NIH) National Institute of Biomedical Imaging and Bioengineering (NIBIB) Research Education Programs for Residents and Clinical Fellows Grant ( R25EB025787-01 ); the National Institute for Dental and Craniofacial Research Establishing Outcome Measures Award ( 1R01DE025248 / R56DE025248 ) and Academic Industrial Partnership Grant ( R01DE028290 ); NCI Early Phase Clinical Trials in Imaging and Image-Guided Interventions Program ( 1R01CA218148 ); an NIH/NCI Cancer Center Support Grant (CCSG) Pilot Research Program Award from the UT MD Anderson CCSG Radiation Oncology and Cancer Imaging Program ( P30CA016672 ); an NIH/NCI Head and Neck Specialized Programs of Research Excellence ( SPORE ) Developmental Research Program Award (P50 CA097007); NIH Big Data to Knowledge (BD2K) Program of the National Cancer Institute (NCI) Early Stage Development of Technologies in Biomedical Computing, Informatics, and Big Data Science Award (1R01CA214825), National Science Foundation (NSF), Division of Mathematical Sciences, Joint NIH/NSF Initiative on Quantitative Approaches to Biomedical Big Data ( QuBBD ) Grant ( NSF 1557679 ); NSF Division of Civil, Mechanical, and Manufacturing Innovation (CMMI) grant ( NSF 1933369 ); the Stiefel Oropharyngeal Research Fund of the University of Texas MD Anderson Cancer ; and the MD Anderson Program in Image-guided Cancer Therapy . Dr. Fuller has received direct industry grant support, in-kind hardware, honoraria, and travel funding from Elekta AB . Dr. Koay was supported by funding from the Radiation Oncology Strategic Initiatives (ROSI) at MD Anderson. Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2021",

month = sep,

doi = "10.1016/j.ctro.2021.08.004",

language = "English (US)",

volume = "30",

pages = "78--83",

journal = "Clinical and Translational Radiation Oncology",

issn = "2405-6308",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Factors associated with complex oral treatment device usage in patients with head and neck cancer

AU - Palasi, Stephen

AU - Zhang, Ning

AU - Bankston, Mikaela

AU - Godby, Joy

AU - Burrows, Hannah

AU - Lagunas, Jennifer

AU - Perkison, William

AU - Gunn, Brandon

AU - Chambers, Mark S.

AU - Rosenthal, David I.

AU - Morrison, William

AU - Garden, Adam

AU - Fuller, Clifton David

AU - Giordano, Sharon

AU - Koay, Eugene J.

N1 - Funding Information: This research was supported, in part, by CPRIT RP160674, Komen SAC150061 and P30 CA016672. Dr. Fuller received funding and salary support from: the National Institutes of Health (NIH) National Institute of Biomedical Imaging and Bioengineering (NIBIB) Research Education Programs for Residents and Clinical Fellows Grant ( R25EB025787-01 ); the National Institute for Dental and Craniofacial Research Establishing Outcome Measures Award ( 1R01DE025248 / R56DE025248 ) and Academic Industrial Partnership Grant ( R01DE028290 ); NCI Early Phase Clinical Trials in Imaging and Image-Guided Interventions Program ( 1R01CA218148 ); an NIH/NCI Cancer Center Support Grant (CCSG) Pilot Research Program Award from the UT MD Anderson CCSG Radiation Oncology and Cancer Imaging Program ( P30CA016672 ); an NIH/NCI Head and Neck Specialized Programs of Research Excellence ( SPORE ) Developmental Research Program Award (P50 CA097007); NIH Big Data to Knowledge (BD2K) Program of the National Cancer Institute (NCI) Early Stage Development of Technologies in Biomedical Computing, Informatics, and Big Data Science Award (1R01CA214825), National Science Foundation (NSF), Division of Mathematical Sciences, Joint NIH/NSF Initiative on Quantitative Approaches to Biomedical Big Data ( QuBBD ) Grant ( NSF 1557679 ); NSF Division of Civil, Mechanical, and Manufacturing Innovation (CMMI) grant ( NSF 1933369 ); the Stiefel Oropharyngeal Research Fund of the University of Texas MD Anderson Cancer ; and the MD Anderson Program in Image-guided Cancer Therapy . Dr. Fuller has received direct industry grant support, in-kind hardware, honoraria, and travel funding from Elekta AB . Dr. Koay was supported by funding from the Radiation Oncology Strategic Initiatives (ROSI) at MD Anderson. Publisher Copyright: © 2021 The Author(s)

PY - 2021/9

Y1 - 2021/9

N2 - Purpose: The objective was to identify clinical and epidemiological factors associated with utilization of a complex oral treatment device (COTD), which may decrease toxicity in patients undergoing radiation therapy for head and neck cancer (HNC).Materials and Methods: We retrospectively reviewed data from 1992 to 2013 in the Surveillance, Epidemiology, and End Results (SEER)-Medicare databases to analyze COTD usage during intensity-modulated radiation therapy (IMRT) for patients diagnosed with cancer of the tongue, floor of mouth, nasopharynx, tonsil, or oropharynx. Patients with a radiation simulation and complex treatment device code within 4 weeks before the first IMRT claim were identified as meeting COTD usage criteria. Demographic, regional, tumor, and treatment data were analyzed.Results: Out of 4511 patients who met eligibility criteria, 1932 patients (42.8%) did not utilize a COTD while 2579 (57.2%) met usage criteria. COTD utilization increased over time (36.36% usage in 1992 vs. 67.44% usage in 2013, p < .0001). Patients less likely to receive a COTD included those aged 86 years or older compared to those aged 66-70 (OR = 0.713, 95% CI: 0.528-0.962), male patients (OR = 0.817, 95% CI: 0.710-0.941), non-Hispanic Black patients compared to non-Hispanic White patients (OR = 0.750, 95% CI: 0.582-0.966), and Louisiana residents (OR = 0.367, 95% CI: 0.279-0.483). Cancer site, grade, stage, or function of IMRT had no significant association with COTD usage. Conclusions: This study serves as the first known SEER-Medicare review of COTD utilization. Despite an increase in COTD usage over time, our results indicate age, gender, and geographic disparities are associated with utilization. Further research and development into methods that increase availability of COTDs may help increase utilization in specific patient populations.

AB - Purpose: The objective was to identify clinical and epidemiological factors associated with utilization of a complex oral treatment device (COTD), which may decrease toxicity in patients undergoing radiation therapy for head and neck cancer (HNC).Materials and Methods: We retrospectively reviewed data from 1992 to 2013 in the Surveillance, Epidemiology, and End Results (SEER)-Medicare databases to analyze COTD usage during intensity-modulated radiation therapy (IMRT) for patients diagnosed with cancer of the tongue, floor of mouth, nasopharynx, tonsil, or oropharynx. Patients with a radiation simulation and complex treatment device code within 4 weeks before the first IMRT claim were identified as meeting COTD usage criteria. Demographic, regional, tumor, and treatment data were analyzed.Results: Out of 4511 patients who met eligibility criteria, 1932 patients (42.8%) did not utilize a COTD while 2579 (57.2%) met usage criteria. COTD utilization increased over time (36.36% usage in 1992 vs. 67.44% usage in 2013, p < .0001). Patients less likely to receive a COTD included those aged 86 years or older compared to those aged 66-70 (OR = 0.713, 95% CI: 0.528-0.962), male patients (OR = 0.817, 95% CI: 0.710-0.941), non-Hispanic Black patients compared to non-Hispanic White patients (OR = 0.750, 95% CI: 0.582-0.966), and Louisiana residents (OR = 0.367, 95% CI: 0.279-0.483). Cancer site, grade, stage, or function of IMRT had no significant association with COTD usage. Conclusions: This study serves as the first known SEER-Medicare review of COTD utilization. Despite an increase in COTD usage over time, our results indicate age, gender, and geographic disparities are associated with utilization. Further research and development into methods that increase availability of COTDs may help increase utilization in specific patient populations.

KW - Head and neck cancer

KW - Oral mucositis

KW - Radiation

KW - SEER-Medicare

KW - Stent

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JO - Clinical and Translational Radiation Oncology

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ER -

Factors associated with complex oral treatment device usage in patients with head and neck cancer

Abstract

Keywords

ASJC Scopus subject areas

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