Nagatani Akiko, Ogawa Yumiko, Sunaga Tomiko, Tomura Kazuki, Naito Yuki, Fujii Naokazu, Okabe Takayuki, Hashimoto Touji, Kogo Mari, Sasaki Tadanori
Departmant of Hospital Pharmaceutics, School of Pharmacy, Showa University.
Yakugaku Zasshi. 2017;137(2):221-225. doi: 10.1248/yakushi.16-00077.
Radiotherapy (RT) and chemoradiotherapy (CRT) is widely accepted as the standard treatment for head and neck cancer (HNC). Oral mucositis (OM) often develops as an adverse reaction in HNC patients that receive RT or CRT involving S-1. However, little is known about the risk factors for OM in HNC patients. We retrospectively evaluated patients' pre-treatment clinical data in order to identify the risk factors for severe OM in HNC patients that are treated with RT or CRT involving S-1. We analyzed the cases of 129 patients who received RT or CRT involving S-1 for HNC. The endpoint of the survey was the occurrence of severe OM (≥grade 2). Risk factors that were significantly related to severe OM were identified using logistic regression analysis. The patients' mean age was 69.3±10.1 years, and 118 (92%) of the patients were male. The primary tumor was located in the oropharynx in 21.7% of cases. Severe OM occurred in 85.0% of cases. In the univariate analysis, the following variables were found to be associated with severe OM: age, the type of radiotherapy, disease stage, and chemotherapy. In the multivariate analysis, the location of the primary tumor and chemotherapy were identified as significant risk factors that contributed independently to the risk of severe OM (p<0.05). Our analysis suggests that cancer of the oropharynx and CRT are important risk factors for severe OM in HNC patients that undergo RT or CRT involving S-1.
放射治疗（RT）和放化疗（CRT）被广泛认为是头颈部癌（HNC）的标准治疗方法。口腔黏膜炎（OM）常作为接受涉及S-1的RT或CRT的HNC患者的不良反应而出现。然而，关于HNC患者发生OM的危险因素知之甚少。我们回顾性评估了患者的治疗前临床数据，以确定接受涉及S-1的RT或CRT的HNC患者发生严重OM的危险因素。我们分析了129例接受涉及S-1的RT或CRT治疗的HNC患者的病例。调查的终点是严重OM（≥2级）的发生情况。使用逻辑回归分析确定与严重OM显著相关的危险因素。患者的平均年龄为69.3±10.1岁，其中118例（92%）为男性。21.7%的病例中，原发肿瘤位于口咽。85.0%的病例发生了严重OM。在单因素分析中，发现以下变量与严重OM相关：年龄、放疗类型、疾病分期和化疗。在多因素分析中，原发肿瘤的位置和化疗被确定为严重OM风险的独立显著危险因素（p<0.05）。我们的分析表明，口咽癌和CRT是接受涉及S-1的RT或CRT的HNC患者发生严重OM的重要危险因素。
