Aspiration pneumonia after chemo-intensity-modulated radiation therapy of oropharyngeal carcinoma and its clinical and dysphagia-related predictors
Aspiration pneumonia after chemo-intensity-modulated radiation therapy of oropharyngeal carcinoma and its clinical and dysphagia-related predictors
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DOI：
10.1002/hed.23275
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发表时间：
2014-01-01
影响因子：
2.9
通讯作者：
Eisbruch, Avraham
中科院分区：
文献类型：
--
作者：
Hunter, Klaudia U.;Lee, Oliver E.;Eisbruch, Avraham
BackgroundThe的目的，这项研究是评估吸入性肺炎（AsPn）率和预测因素后，化疗照射头颈cancer.MethodsThe是一项前瞻性研究的72例III期至IV期口咽癌治疗明确与调强放疗（IMRT）同时每周卡铂和紫杉醇。AsPn的前瞻性记录和吞咽困难进行了评估，通过2年的治疗后，由historical额定（通用毒性标准版本[CTCAE]）评分，患者报告的分数，和videoflucorescence.Results16例（20%）开发AsPn。预测因素包括T分类（p = 0.01）、视频荧光透视检测到的误吸（视频荧光透视-asp; p = 0.0007）和患者报告的吞咽困难（p = 0.02 - 0.0003），但非非完全评定的吞咽困难（p = 0.4）。结合T分类，患者报告吞咽困难，和videofluoroscopy-asp，提供了最好的预测model.ConclusionAsPn仍然是一个低估的后果，头部和颈部癌症的化疗照射。这些数据支持使用患者报告的吞咽困难来识别需要视频透视评价以采取预防措施的高风险患者。通过减少吞咽结构的辐射剂量和减少预期效果良好的患者的治疗强度来降低视频透视-asp率，可能会降低AsPn率。(c)2013 Wiley Periodicals，Inc.头颈部36：120-125，2014
BackgroundThe purpose of this study was to assess aspiration pneumonia (AsPn) rates and predictors after chemo-irradiation for head and neck cancer.MethodsThe was a prospective study of 72 patients with stage III to IV oropharyngeal cancer treated definitively with intensity-modulated radiotherapy (IMRT) concurrent with weekly carboplatin and paclitaxel. AsPn was recorded prospectively and dysphagia was evaluated longitudinally through 2 years posttherapy by observer-rated (Common Toxicity Criteria version [CTCAE]) scores, patient-reported scores, and videofluoroscopy.ResultsSixteen patients (20%) developed AsPn. Predictive factors included T classification (p = .01), aspiration detected on videofluoroscopy (videofluoroscopy-asp; p = .0007), and patient-reported dysphagia (p = .02-.0003), but not observer-rated dysphagia (p = .4). Combining T classification, patient reported dysphagia, and videofluoroscopy-asp, provided the best predictive model.ConclusionAsPn continues to be an under-reported consequence of chemo-irradiation for head and neck cancer. These data support using patient-reported dysphagia to identify high-risk patients requiring videofluoroscopy evaluation for preventive measures. Reducing videofluoroscopy-asp rates, by reducing swallowing structures radiation doses and by trials reducing treatment intensity in patients predicted to do well, are likely to reduce AsPn rates. (c) 2013 Wiley Periodicals, Inc. Head Neck36: 120-125, 2014