Risk factors for aspiration pneumonia after definitive chemoradiotherapy or bio-radiotherapy for locally advanced head and neck cancer: a monocentric case control study

BMC Cancer

Research Article

Keita Mori¹  Takashi Yurikusa²  Sadayuki Kawai³  Takahiro Tsushima³  Akira Fukutomi³  Akiko Todaka³  Satoshi Hamauchi³  Tomoya Yokota³  Yosuke Kito³  Hirofumi Yasui³  Yukio Yoshida³  Tetsuro Onitsuka⁴  Yusuke Onozawa⁵  Hirofumi Ogawa⁶  Tsuyoshi Onoe⁶ 

[1] Clinical Research Center, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan;Division of Dental and Oral Surgery, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan;Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, 411-8777, Sunto-gun, Shizuoka, Japan;Division of Head and Neck Surgery, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan;Division of Medical Oncology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan;Division of Radiation Oncology and Proton Therapy, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan;

关键词: Head and neck cancer;    Aspiration pneumonia;    Risk factor;    Chemoradiotherapy;    Case–control study;   

DOI  :  10.1186/s12885-017-3052-8

 received in 2016-08-26, accepted in 2017-01-10,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundChemoradiotherapy (CRT) and bio-radiotherapy (BRT) are recognized as standard therapies for head and neck cancer (HNC). Aspiration pneumonia after CRT or BRT is a common late adverse event. Our aim in this study was to evaluate the cause-specific incidence of aspiration pneumonia after CRT or BRT and to identify its clinical risk factors.MethodsWe performed a retrospective analysis of 305 patients with locally advanced HNC treated by CRT or BRT between August 2006 and April 2015.ResultsOf these 305 patients, 65 (21.3%) developed aspiration pneumonia after treatment. The median onset was 161 days after treatment. The two-year cause-specific cumulative incidence by CRT or BRT was 21.0%. Multivariate analysis revealed five independent risk factors for aspiration pneumonia, namely, habitual alcoholic consumption, use of sleeping pills at the end of treatment, poor oral hygiene, hypoalbuminemia before treatment, and the coexistence of other malignancies. A predictive model using these risk factors and treatment efficacy was constructed, dividing patients into low- (0–2 predictive factors), moderate- (3–4 factors), and high-risk groups (5–6 factors), the two-year cumulative incidences of aspiration pneumonia of which were 3.0, 41.6, and 77.3%, respectively. Aspiration pneumonia tended to be associated with increased risk of death, although this was not statistically significant (multivariate-adjusted hazard ratio 1.39, P = 0.18).ConclusionThe cause-specific incidence and clinical risk factors for aspiration pneumonia after definitive CRT or BRT were investigated in patients with locally advanced HNC. Our predictive model may be useful for identifying patients at high risk for aspiration pneumonia.

【 授权许可】

CC BY   
© The Author(s). 2017