头颈部癌症患者经高强度调强放疗治疗的 5 年队列研究中，喂养管的存在及持续时间。

Presence and duration of feeding tube in a 5-year cohort of patients with head and neck cancer treated with curative intensity-modulated radiation therapy.

机构信息

Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.

Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.

出版信息

Head Neck. 2021 May;43(5):1610-1620. doi: 10.1002/hed.26638. Epub 2021 Feb 13.

DOI:10.1002/hed.26638

PMID:33580567

Abstract

BACKGROUND

Our study assessed post-radiation therapy (RT) G-tube presence, duration, and clinical predictors in patients with head and neck cancer (HNC).

METHODS

We identified those 1-5-years post-RT with stage III/IV nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, or unknown primaries. Logistic regression identified predictors of post-RT G-tube presence, Kaplan-Meier analysis estimated G-tube days, and log-rank test compared by tumor site.

RESULTS

The 977 patients had mean age 60.6 ± 11.6 years, 804 (82.3%) male, 764 (78.2%) stage IV, and 618 (63.3%) oropharyngeal primaries. All patients received intensity-modulated RT (IMRT), 571 (58.4%) received chemotherapy, and 698 (71.4%) prophylactic G-tube. G-tube prevalence 1- and 5-years post-IMRT was 7.1% and 4.8%, respectively. Median post-IMRT G-tube days were overall 63 (95%CI: 56-70), nasopharynx 119 (95%CI: 109-131), oropharynx 57 (95%CI: 51-68), hypopharynx 126 (95%CI: 77-256), larynx 53 (95%CI: 21-63), unknown 30 (95%CI: 17-55), of which hypopharynx was highest p < 0.001.

CONCLUSIONS

At an institution offering prophylactic G-tube for patients with advanced HNC, no differences were found in yearly G-tube use 1-5 years post-IMRT. Across all patients, median post-IMRT days with G-tube was 63 day but those with hypopharyngeal tumors registered the most days.

摘要

背景

我们的研究评估了头颈部癌症（HNC）患者放疗后（RT）存在、持续时间和临床预测因素。

方法

我们确定了 1-5 年内患有 III/IV 期鼻咽、口咽、下咽、喉或未知原发灶的患者。逻辑回归确定了放疗后 G 管存在的预测因素，Kaplan-Meier 分析估计了 G 管天数，对数秩检验比较了肿瘤部位。

结果

977 例患者的平均年龄为 60.6±11.6 岁，804 例（82.3%）为男性，764 例（78.2%）为 IV 期，618 例（63.3%）为口咽原发灶。所有患者均接受了调强放疗（IMRT），571 例（58.4%）接受了化疗，698 例（71.4%）预防性放置了 G 管。放疗后 1 年和 5 年 G 管的患病率分别为 7.1%和 4.8%。IMRT 后中位 G 管天数总体为 63 天（95%CI：56-70），鼻咽部 119 天（95%CI：109-131），口咽部 57 天（95%CI：51-68），下咽 126 天（95%CI：77-256），喉 53 天（95%CI：21-63），未知部位 30 天（95%CI：17-55），其中下咽部位最高，p<0.001。