Low Skeletal Muscle Mass Is a Risk Factor for Aspiration Pneumonia During Chemoradiotherapy
Low Skeletal Muscle Mass Is a Risk Factor for Aspiration Pneumonia During Chemoradiotherapy
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DOI：
10.1002/lary.29165
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发表时间：
2020-10-08
期刊：
影响因子：
2.6
通讯作者：
Yoshizaki, Tomokazu
中科院分区：
文献类型：
--
作者：
Endo, Kazuhira;Ueno, Takayoshi;Yoshizaki, Tomokazu
目的探讨头颈部鳞状细胞癌（HNSCC）患者放化疗前骨骼肌质量指数（SMI）是否是吸入性肺炎的预测因子，以及SMI降低与总生存期（OS）的关系。方法回顾性分析2010-2019年接受CRT治疗的HNSCC患者的资料。患者接受放疗和顺铂化疗的联合治疗（3个周期，80 mg/m2顺铂，第1、22和43天）。吸入性肺炎定义为同时存在主观和客观症状。生成Kaplan-Meier曲线以分析存活率。结果159例患者中，36例（22.6%）在治疗过程中发生吸入性肺炎。肺炎患者和非肺炎患者的中位SMI分别为12.4 cm（2）/m（2）（9.0-20.7）和13.6 cm（2）/m（2）（8.1-19.7）（P <0.01）。多变量logistic回归分析显示，SMI是吸入性肺炎的唯一独立预测因子（P= 0.0026）。低SMI患者的平均OS显著短于正常SMI患者（66.9个月vs. 92.7个月，P= 0.001）。结论治疗前低SMI可预测接受CRT的HNSCC患者发生吸入性肺炎，是OS的一个强的负性预后预测因子。可为低SMI高风险患者提供支持性治疗。这项研究是第一个报告SMI作为HNSCC的预后预测因子。喉镜，2020
Objectives This study aimed to investigate whether pretreatment skeletal muscle mass index (SMI) is a predictor for the risk of aspiration pneumonia and to explore the relationship between low SMI and overall survival (OS) in patients with head and neck squamous cell carcinoma (HNSCC) receiving chemoradiotherapy (CRT). Methods We retrospectively reviewed the data of patients with HNSCC who received CRT during 2010-2019. Patients received a combination of radiotherapy and cisplatin-based chemotherapy (3 cycles of 80 mg/m(2)cisplatin on days 1, 22, and 43). Aspiration pneumonia were defined as the presence of both subjective and objective symptoms. Kaplan-Meier curves were generated to analyze survival. Results Among the 159 patients, 36 (22.6%) developed aspiration pneumonia during treatment. Median SMI in patients with and without pneumonia was 12.4 cm(2)/m(2)(9.0-20.7) and 13.6 cm(2)/m(2)(8.1-19.7), respectively (P < .01). Multivariate logistic regression revealed that SMI was the only independent predictor of aspiration pneumonia (P= .0026). Mean OS was significantly shorter for patients with low SMI than for patients with normal SMI (66.9 months vs. 92.7 months,P= .001). Conclusion Pretreatment low SMI predicts development of aspiration pneumonia and is a strong negative prognostic predictor for OS in patients with HNSCC undergoing CRT. Supportive treatment can be provided to patients at high risk of a low SMI. This study is the first to report SMI as a prognostic predictor in HNSCC.Laryngoscope, 2020