Risk of xerostomia in association with the receipt of radiation therapy in older patients with head and neck cancer.
Risk of xerostomia in association with the receipt of radiation therapy in older patients with head and neck cancer.
复制标题
患有头颈癌的老年患者出现口干症的风险与接受放射治疗有关。
DOI：
10.1097/mjt.0b013e3181c960dc
复制
发表时间：
2011
影响因子：
4.2
通讯作者：
Du,XianglinL
中科院分区：
文献类型：
--
作者：
Liu,Chih-Chin;Xia,Rui;Guadagnolo,Ashleigh;Cormier,JaniceN;Du,XianglinL
本研究的目的是评估在一个大型人群队列中诊断为头颈癌（HNC）的老年患者中与接受放射治疗（RT）相关的口干症的发生率和风险。该研究包括10，387名从1991年至2002年被诊断为65岁或以上的HNC癌症的男性和女性，这些患者来自16个监测，流行病学和最终结果-医疗保险相关数据的登记处。如果在HNC诊断日期后30天内至少有2次索赔（诊断代码527.7），则将患者定义为口干症。在中位随访2.4年时，接受放疗联合或不联合化疗的患者与既不接受放疗也不接受化疗的患者相比，发生口干症的累积发生率更高（分别为5.6%和3.8% vs. 0.5%）。与既未接受RT也未接受化疗的患者相比，接受RT同时接受化疗的患者发生口干症的可能性高9倍（风险比= 9.13，95%置信区间= 6.68-12.48），而接受RT但未接受化疗的患者发生口干症的可能性高6倍以上（6.29，4.72-8.37）。当患者按肿瘤分期和解剖肿瘤部位分层时，这种关联的强度相似。发生口干症的风险与种族、婚姻和社会经济地位之间没有显著关联。无论手术治疗类型、肿瘤分期或解剖学肿瘤部位如何，用于治疗HNC的放射治疗均与发生口干症的显著风险相关。
The purpose of this study was to assess the incidence rate and risk of developing xerostomia in association with the receipt of radiation therapy (RT) among a large population-based cohort of elderly patients diagnosed with head and neck cancer (HNC). The study consisted of 10,387 men and women diagnosed with incident HNC cancer at age 65 years or older from 1991 through 2002, identified from the 16 registries of the Surveillance, Epidemiology and End Results-Medicare linked data. Patients were defined as having xerostomia if there were at least 2 claims (for diagnosis code 527.7) at 30 days apart after the date of HNC diagnosis. Patients receiving RT either with or without chemotherapy had a higher cumulative incidence of developing xerostomia compared with those with neither radiotherapy nor chemotherapy (5.6% and 3.8%, respectively vs. 0.5%) at a median follow-up of 2.4 years. Patients who received RT with concurrent chemotherapy were 9 times more likely to develop xerostomia (hazard ratio= 9.13, 95% confidence interval= 6.68-12.48) compared with patients who received neither RT nor chemotherapy, whereas those who received RT without chemotherapy were over 6 times more likely to develop xerostomia (6.29, 4.72-8.37). The strength of this association was similar when patients were stratified by tumor stage and anatomic tumor site. There was no significant association between the risk of developing xerostomia and ethnicity, marital, and socioeconomic status. Radiation therapy for the treatment of HNC is associated with a significant risk of developing xerostomia regardless of type of surgical treatment rendered, tumor stage, or anatomic tumor site.