Aspiration pneumonia after chemo-intensity-modulated radiation therapy of oropharyngeal carcinoma and its clinical and dysphagia-related predictors

被引：82

作者：

Hunter, Klaudia U. ^{[1
]}

Lee, Oliver E. ^{[2
]}

Lyden, Teresa H. ^{[3
]}

Haxer, Marc J. ^{[3
]}

Feng, Felix Y. ^{[1
]}

Schipper, Mathew ^{[1
,2
]}

Worden, Francis ^{[4
]}

Prince, Mark E. ^{[5
]}

McLean, Scott A. ^{[5
]}

Wolf, Gregory T. ^{[5
]}

Bradford, Carol R. ^{[5
]}

Chepeha, Douglas B. ^{[5
]}

Eisbruch, Avraham ^{[1
]}

机构：

[1] Univ Michigan, Dept Radiat Oncol, Ann Arbor, MI 48109 USA

[2] Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA

[3] Univ Michigan, Dept Speech Language Pathol, Ann Arbor, MI 48109 USA

[4] Univ Michigan, Dept Med Hematol Oncol, Ann Arbor, MI 48109 USA

[5] Univ Michigan, Dept Otorhinolaryngol Head & Neck Surg, Ann Arbor, MI 48109 USA

来源：

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2014年 / 36卷 / 01期

基金：

美国国家卫生研究院;

关键词：

oropharyngeal cancer; head and neck cancer; IMRT; aspiration pneumonia; dysphagia; NECK-CANCER PATIENTS; QUALITY-OF-LIFE; CONCURRENT CHEMORADIATION; HEAD; TOXICITY; PATIENT; RADIOTHERAPY;

D O I：

10.1002/hed.23275

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

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

引用

页码：120 / 125

页数：6

共 22 条

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