Aspiration pneumonia in patients treated with radiotherapy for head and neck cancer
Aspiration pneumonia in patients treated with radiotherapy for head and neck cancer
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DOI：
10.3109/0284186x.2012.742205
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发表时间：
2013-02-01
期刊：
影响因子：
3.1
通讯作者：
Grau, Cai
中科院分区：
文献类型：
--
作者：
Mortensen, Hanna R.;Jensen, Kenneth;Grau, Cai
据报道，吸入性和吸入性肺炎在接受化疗-放疗的头颈部癌症人群中的发病率很高。本研究的目的是调查吸入性肺炎的发病率和死亡率在头颈部癌症患者接受根治性放射治疗与或不同时每周顺铂的一系列研究。材料和方法。2006年至2008年，在丹麦奥胡斯的一个转诊中心，共有324名连续患者接受了治疗性预期放疗治疗头颈癌，并进行了中位4.3年的随访。从DAHANCA数据库获得患者、肿瘤和治疗特征的数据。入院数据来自国家患者登记处。从国家死亡原因登记处获得了关于所有死亡和死亡原因的数据。结果在纳入的324例患者中，32%发生重度吞咽困难。共有18例患者发生吸入性肺炎，对应的发病率为29例（95% CI 17-46）/1000人-年，放疗后第一年的发病率比例为5.3%（95% CI 3.1-8.3%）;显著风险因素包括管饲、临床分期、重度吞咽困难和治疗反应不完全。18例吸入性肺炎患者中有3例死于该并发症。结论吞咽困难相关的吸入性肺炎和吸入性肺炎是加速放疗的严重和潜在致命的治疗并发症，但发生频率低于以前的报告。
Aspiration and aspiration pneumonia has been reported with a high incidence in head and neck cancer populations treated with chemo-radiotherapy. The aim of this study was to investigate the incidence and mortality of aspiration pneumonia in an unselected series of head and neck cancer patients treated with curative radiotherapy with or without concurrent weekly cisplatin. Material and methods. A total of 324 consecutive patients treated with curative intended radiotherapy for head and neck cancer in a single Danish referral center in Aarhus from 2006 to 2008 were included and followed for a median of 4.3 years. Data on patient, tumor and treatment characteristics were obtained from the DAHANCA database. Data on hospital admissions were obtained from the National Patient Registry. Data from the National Registry of Causes of Death were obtained on all deaths and causes of death. Results. Severe dysphagia occurred in 32% of the 324 patients included. A total of 18 patients developed aspiration pneumonia, corresponding to an incidence rate of 29 (95% CI 17-46) per 1000 person-years and an incidence proportion of 5.3% (95% CI 3.1-8.3%) in the first year after radiotherapy; significant risk factors included tube feeding, clinical stage, severe dysphagia and incomplete response to treatment. Three of the 18 patients with aspiration pneumonia died from this complication. Conclusion. Dysphagia-related aspiration and aspiration pneumonia are serious and potentially fatal treatment complications to accelerated radiotherapy, but occur less frequent than previously reported.