Murono Shigeyuki, Tsuji Akira, Endo Kazuhira, Kondo Satoru, Wakisaka Naohiro, Yoshizaki Tomokazu
Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan,
Support Care Cancer. 2015 Feb;23(2):457-62. doi: 10.1007/s00520-014-2388-8. Epub 2014 Aug 17.
We aimed to identify tumor- and treatment-related factors predicting gastrostomy tube dependence after concurrent chemoradiotherapy (CCRT) for hypopharyngeal cancer.
We performed a retrospective review of all patients with hypopharyngeal cancer treated with CCRT between 2002 and 2012 except for those with residual or recurrent disease at evaluation. The incidence of gastrostomy tube dependence, defined as complete or almost complete dependence on tube feeding, at 6 months after the completion of treatment was the endpoint. A total of 75 patients were analyzed in this study.
Twelve patients (16 %) showed gastrostomy tube dependence. Among tumor-related factors, the subsite (posterior wall versus pyriform sinus plus postcricoid) was the most significant factor correlated with gastrostomy tube dependence (p < 0.01 by multivariate analysis). The T category of the primary tumor was also correlated with gastrostomy tube dependence on univariate analysis (p < 0.01). Among treatment-related factors, the radiation dose was not associated with gastrostomy tube dependence. On the other hand, gastrostomy tube dependence was also correlated with the requirement of supportive nutrition with a nasogastric tube at the beginning of and during treatment (both p < 0.01).
Risk factors for gastrostomy tube dependence after the completion of CCRT for hypopharyngeal cancer were identified.
我们旨在确定预测下咽癌同步放化疗（CCRT）后胃造瘘管依赖的肿瘤及治疗相关因素。
我们对2002年至2012年间接受CCRT治疗的所有下咽癌患者进行了回顾性研究，但不包括评估时有残留或复发疾病的患者。治疗结束6个月时胃造瘘管依赖的发生率（定义为完全或几乎完全依赖管饲）为终点。本研究共分析了75例患者。
12例患者（16%）出现胃造瘘管依赖。在肿瘤相关因素中，亚部位（后壁与梨状窦加环状软骨后区）是与胃造瘘管依赖最相关的因素（多因素分析p<0.01）。原发肿瘤的T分类在单因素分析中也与胃造瘘管依赖相关（p<0.01）。在治疗相关因素中，放射剂量与胃造瘘管依赖无关。另一方面，胃造瘘管依赖也与治疗开始时及治疗期间鼻胃管支持性营养的需求相关（两者p<0.01）。
确定了下咽癌CCRT完成后胃造瘘管依赖的危险因素。
