Hiromichi Shirasu1, Tomoya Yokota2, Satoshi Hamauchi1, Yusuke Onozawa3, Hirofumi Ogawa4, Tsuyoshi Onoe4, Tetsuro Onitsuka5, Takashi Yurikusa6, Keita Mori7, Hirofumi Yasui1. 1. Shizuoka Cancer Center, Division of Gastrointestinal Oncology, 1007 Shimonagakubo Nagaizumi-cho Sunto-gun, Shizuoka, 411-8777, Japan. 2. Shizuoka Cancer Center, Division of Gastrointestinal Oncology, 1007 Shimonagakubo Nagaizumi-cho Sunto-gun, Shizuoka, 411-8777, Japan. t.yokota@scchr.jp. 3. Shizuoka Cancer Center, Division of Medical Oncology, Sunto-gun, Shizuoka, Japan. 4. Shizuoka Cancer Center, Division of Radiation Oncology and Proton Therapy, Sunto-gun, Shizuoka, Japan. 5. Shizuoka Cancer Center, Division of Head and Neck Surgery, Sunto-gun, Shizuoka, Japan. 6. Shizuoka Cancer Center, Division of Dentistry and Oral Surgery, Sunto-gun, Shizuoka, Japan. 7. Shizuoka Cancer Center, Clinical Research Center, Sunto-gun, Shizuoka, Japan.
Abstract
BACKGROUND: Aspiration pneumonia is one of the most important side effects of chemoradiotherapy (CRT) and bio-radiotherapy (BRT) in patients with head and neck cancer (HNC). Aspiration pneumonia can lead to cancer-related mortality in HNC patients. However, the relationship between aspiration pneumonia occurring during CRT or BRT for HNC and treatment outcomes in HNC patients is not well characterized. In this study, we assessed the influence of aspiration pneumonia on treatment outcomes and sought to identify the clinical risk factors for aspiration pneumonia during definitive CRT and BRT in HNC patients. METHODS: We retrospectively assessed the data pertaining to patients with locally advanced HNC who received definitive CRT or BRT at the Shizuoka Cancer Center between August 2006 and December 2016. RESULTS: Among the 374 HNC patients who received CRT or BRT, 95 (25.4%) developed aspiration pneumonia during treatment. Aspiration pneumonia was significantly associated with therapeutic response to CRT or BRT (multivariate adjusted odds ratio for complete response, 0.52, p = 0.020) and poor overall survival (multivariate adjusted hazard ratio for overall survival, 1.58, p = 0.024). The multivariate analyses identified four independent factors for aspiration pneumonia: poor oral hygiene, high N-classification, hypoalbuminemia before treatment, and inpatient treatment. CONCLUSIONS: Aspiration pneumonia occurring during CRT or BRT has a detrimental effect on the therapeutic response and survival of HNC patients. Careful attention should be paid to these risk factors for aspiration pneumonia in HNC patients undergoing CRT or BRT.
BACKGROUND:Aspiration pneumonia is one of the most important side effects of chemoradiotherapy (CRT) and bio-radiotherapy (BRT) in patients with head and neck cancer (HNC). Aspiration pneumonia can lead to cancer-related mortality in HNCpatients. However, the relationship between aspiration pneumonia occurring during CRT or BRT for HNC and treatment outcomes in HNCpatients is not well characterized. In this study, we assessed the influence of aspiration pneumonia on treatment outcomes and sought to identify the clinical risk factors for aspiration pneumonia during definitive CRT and BRT in HNCpatients. METHODS: We retrospectively assessed the data pertaining to patients with locally advanced HNC who received definitive CRT or BRT at the Shizuoka Cancer Center between August 2006 and December 2016. RESULTS: Among the 374 HNCpatients who received CRT or BRT, 95 (25.4%) developed aspiration pneumonia during treatment. Aspiration pneumonia was significantly associated with therapeutic response to CRT or BRT (multivariate adjusted odds ratio for complete response, 0.52, p = 0.020) and poor overall survival (multivariate adjusted hazard ratio for overall survival, 1.58, p = 0.024). The multivariate analyses identified four independent factors for aspiration pneumonia: poor oral hygiene, high N-classification, hypoalbuminemia before treatment, and inpatient treatment. CONCLUSIONS:Aspiration pneumonia occurring during CRT or BRT has a detrimental effect on the therapeutic response and survival of HNCpatients. Careful attention should be paid to these risk factors for aspiration pneumonia in HNCpatients undergoing CRT or BRT.
Entities:
Keywords:
Aspiration pneumonia; Chemoradiotherapy; Head and neck cancer; Radiotherapy; Risk factors
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