Risk factors for aspiration pneumonia during concurrent chemoradiotherapy or bio-radiotherapy for head and neck cancer
Risk factors for aspiration pneumonia during concurrent chemoradiotherapy or bio-radiotherapy for head and neck cancer
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DOI：
10.1186/s12885-020-6682-1
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发表时间：
2020-03-04
期刊：
影响因子：
3.8
通讯作者：
Yasui, Hirofumi
中科院分区：
文献类型：
--
作者：
Shirasu, Hiromichi;Yokota, Tomoya;Yasui, Hirofumi
吸入性肺炎是头颈部恶性肿瘤放化疗（CRT）和生物放疗（BRT）的主要副作用之一。吸入性肺炎可导致HNC患者的癌症相关死亡率。然而，CRT或BRT治疗HNC期间发生的吸入性肺炎与HNC患者治疗结局之间的关系尚未得到很好的表征。在这项研究中，我们评估了吸入性肺炎对治疗结果的影响，并试图确定HNC患者在确定性CRT和BRT期间吸入性肺炎的临床危险因素。方法我们回顾性评估了2006年8月至2016年12月在静冈癌症中心接受明确CRT或BRT的局部晚期HNC患者的相关数据。结果374例接受CRT或BRT治疗的HNC患者中，95例（25.4%）在治疗期间发生吸入性肺炎。吸入性肺炎与CRT或BRT的治疗反应显著相关（完全反应的多变量校正比值比，0.52，p = 0.020）和总生存率差（总生存率的多变量校正风险比，1.58，p = 0.024）。多变量分析确定了吸入性肺炎的四个独立因素：口腔卫生不良、高N分类、治疗前低白蛋白血症和住院治疗。结论CRT或BRT期间发生吸入性肺炎对HNC患者的治疗效果和生存率有不利影响。在接受CRT或BRT的HNC患者中，应仔细注意这些吸入性肺炎的危险因素。
Background Aspiration pneumonia is one of the most important side effects of chemoradiotherapy (CRT) and bio-radiotherapy (BRT) in patients with head and neck cancer (HNC). Aspiration pneumonia can lead to cancer-related mortality in HNC patients. However, the relationship between aspiration pneumonia occurring during CRT or BRT for HNC and treatment outcomes in HNC patients is not well characterized. In this study, we assessed the influence of aspiration pneumonia on treatment outcomes and sought to identify the clinical risk factors for aspiration pneumonia during definitive CRT and BRT in HNC patients. Methods We retrospectively assessed the data pertaining to patients with locally advanced HNC who received definitive CRT or BRT at the Shizuoka Cancer Center between August 2006 and December 2016. Results Among the 374 HNC patients who received CRT or BRT, 95 (25.4%) developed aspiration pneumonia during treatment. Aspiration pneumonia was significantly associated with therapeutic response to CRT or BRT (multivariate adjusted odds ratio for complete response, 0.52, p = 0.020) and poor overall survival (multivariate adjusted hazard ratio for overall survival, 1.58, p = 0.024). The multivariate analyses identified four independent factors for aspiration pneumonia: poor oral hygiene, high N-classification, hypoalbuminemia before treatment, and inpatient treatment. Conclusions Aspiration pneumonia occurring during CRT or BRT has a detrimental effect on the therapeutic response and survival of HNC patients. Careful attention should be paid to these risk factors for aspiration pneumonia in HNC patients undergoing CRT or BRT.