放化疗及生物放疗后头颈癌挽救性手术的并发症及手术部位感染
Complication and surgical site infection for salvage surgery in head and neck cancer after chemoradiotherapy and bioradiotherapy.
作者信息
Suzuki Hidenori, Hanai Nobuhiro, Nishikawa Daisuke, Fukuda Yujiro, Hasegawa Yasuhisa
机构信息
Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
出版信息
Auris Nasus Larynx. 2017 Oct;44(5):596-601. doi: 10.1016/j.anl.2016.11.009. Epub 2016 Dec 30.
OBJECTIVE
We aimed to investigate the complications, surgical site infection (SSI), and survival in salvage surgery without free-flap reconstruction for patients with head and neck squamous cell carcinoma who were treated by platinum-based chemoradiotherapy (Plat-CRT) or cetuximab-based bioradiotherapy (Cet-BRT).
METHODS
Thirty-three patients treated by Plat-CRT and six treated by Cet-BRT had salvage surgery. We categorized postoperative complications according to the Clavien-Dindo classification and SSI according to the wound grading scale. Overall survival calculated by Kaplan-Meier method.
RESULTS
Patients with Cet-BRT were significantly associated with the presence of SSI (P<0.01) and grades IIIb-V of the Clavien-Dindo classification (P<0.01) compared with those with Plat-CRT. Patients with Cet-BRT had a significantly lower overall survival than those with Plat-CRT (P<0.05).
CONCLUSION
We demonstrated that patients with Cet-BRT were significantly more associated with the presence of SSI and grades IIIb-V in the Clavien-Dindo classification than those with CRT.
目的
我们旨在调查接受铂类化疗放疗（Plat-CRT）或西妥昔单抗生物放疗（Cet-BRT）治疗的头颈部鳞状细胞癌患者在无游离皮瓣重建的挽救性手术中的并发症、手术部位感染（SSI）及生存率。
方法
33例接受Plat-CRT治疗的患者和6例接受Cet-BRT治疗的患者接受了挽救性手术。我们根据Clavien-Dindo分类法对术后并发症进行分类，并根据伤口分级量表对SSI进行分类。采用Kaplan-Meier法计算总生存率。
结果
与接受Plat-CRT治疗的患者相比，接受Cet-BRT治疗的患者发生SSI（P<0.01）及Clavien-Dindo分类中的IIIb-V级并发症（P<0.01）的相关性显著更高。接受Cet-BRT治疗的患者的总生存率显著低于接受Plat-CRT治疗的患者（P<0.05）。
结论
我们证明，与接受CRT治疗的患者相比，接受Cet-BRT治疗的患者发生SSI及Clavien-Dindo分类中的IIIb-V级并发症的相关性显著更高。
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