A Retrospective Study of G-Tube Use in Japanese Patients Treated with Concurrent Chemoradiotherapy for Hypopharyngeal Cancer.
A Retrospective Study of G-Tube Use in Japanese Patients Treated with Concurrent Chemoradiotherapy for Hypopharyngeal Cancer.
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DOI：
10.1371/journal.pone.0161734
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Fukuda S
中科院分区：
文献类型：
--
作者：
Homma A;Hatakeyama H;Mizumachi T;Kano S;Sakashita T;Kuramoto R;Nakamaru Y;Onimaru R;Tsuchiya K;Yoshida D;Yasuda K;Shirato H;Fukuda S
头颈部鳞状细胞癌患者同步放化疗后的晚期毒性反应，如吞咽困难，近来受到了广泛关注。据报道，在西方国家，CCRT后1年的胃造口术管（G管）依赖率为16.7%-42.9%。我们评估了在我院治疗的下咽癌（HPC）患者接受CCRT后的吞咽结果，并与以前的报告进行了比较。我们回顾了2006年至2013年期间在日本札幌的北海道大学医院接受放疗联合静脉或动脉化疗的96例HPC患者。在CCRT后1个月，13例患者（13.7%）使用了G管，而5/91例（5.5%）和4/81例（4.9%）分别在3个月和6个月使用了G管。2例患者在CCRT后12个月和24个月使用了G管（G管使用率：12个月时为2.8%，24个月时为3.2%）。变量女性、原发性后壁、IV期、ECOG体力状态2分和吸烟状态与CCRT后12个月时G管使用显著相关，而顺铂给药途径与G管使用无关（p = 0.303）。根据先前的报告，日本患者长达1年的G管使用率可能低于西方患者。特别是，日本患者比西方患者更快恢复口服摄入。需要按种族进一步研究CCRT后吞咽困难的发生率，以澄清CCRT后吞咽困难的差异。
Late toxicity after concurrent chemoradiotherapy (CCRT), such as dysphagia, in patients with squamous cell carcinoma of the head and neck has received a good deal of attention recently. The gastrostomy tube (G-tube) dependence rate 1 year after CCRT was reported to be 16.7–42.9% in Western countries. We evaluated swallowing outcomes after CCRT in patients with hypopharyngeal cancer (HPC) treated in our hospital and compared them with previous reports. We reviewed 96 consecutive patients with a HPC treated by radiotherapy with intravenous or intra-arterial chemotherapy between 2006 and 2013 at Hokkaido University Hospital, Sapporo, Japan. At 1 month after CCRT, 13 patients (13.7%) used a G-tube, whereas 5/91 (5.5%) and 4/81 (4.9%) used a G-tube at 3 and 6 months, respectively. Two patients used a G-tube at 12 and 24 months after CCRT (G-tube use rate: 2.8% at 12 months, and 3.2% at 24 months). The variables female, posterior wall primary, stage IV, ECOG performance status of 2, and smoking status were significantly associated with G-tube use at 12 months after CCRT, whereas the route of cisplatin administration was not related to G-tube use (p = 0.303). The G-tube use rate up to 1year could be lower in Japanese patients than in Western patients according to previous reports. In particular, Japanese patients resume oral intake sooner than Western patients. Further study of the incidence of dysphagia after CCRT by ethnicity is required to clarify the differences in dysphagia after CCRT.