Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Lübeck, Lübeck, Germany.
Anticancer Res. 2022 May;42(5):2657-2663. doi: 10.21873/anticanres.15743.
BACKGROUND/AIM: Many head-and-neck cancer patients receive radiotherapy, which may be associated with significant toxicities. Xerostomia is considered one of the most debilitating late adverse events. This study was performed to identify risk factors for xerostomia.
Several characteristics were investigated for associations with late xerostomia in 159 patients irradiated for head-and-neck cancer including age, sex, tumor site and size, underlying pathology, histologic grading, upfront resection, systemic treatment, and type and dose of radiotherapy.
Ninety (57%) and 35 (22%) patients experienced grade ≥2 and ≥3 xerostomia, respectively. Grade ≥2 xerostomia was significantly associated with tumor site (nasopharynx/oropharynx/oral cavity/floor of mouth, p=0.049). Grade ≥3 xerostomia was significantly associated with age ≥61 years (p=0.035); trends were found for tumor site (p=0.088), bilateral nodal involvement (p=0.093), definitive treatment (p=0.082), and systemic treatment (p=0.055).
Risk factors for xerostomia following radiotherapy of head-and-neck cancers were identified including older age, unfavorable tumor site, bilateral involvement of lymph nodes, definitive treatment, and addition of systemic therapies. For patients with risk factors, sparing of the salivary glands is particularly important.
背景/目的：许多头颈部癌症患者接受放疗，这可能与严重的毒性有关。口干被认为是最具致残性的晚期不良反应之一。本研究旨在确定口干的危险因素。
对 159 例头颈部癌症放疗患者的多种特征与晚期口干进行了相关性分析，包括年龄、性别、肿瘤部位和大小、基础病理、组织学分级、 upfront 切除术、系统治疗以及放疗的类型和剂量。
90 例（57%）和 35 例（22%）患者分别出现了≥2 级和≥3 级口干。≥2 级口干与肿瘤部位显著相关（鼻咽/口咽/口腔/口底，p=0.049）。≥3 级口干与年龄≥61 岁显著相关（p=0.035）；肿瘤部位（p=0.088）、双侧淋巴结受累（p=0.093）、确定性治疗（p=0.082）和系统治疗（p=0.055）有趋势。
确定了头颈部癌症放疗后口干的危险因素，包括年龄较大、肿瘤部位不利、淋巴结双侧受累、确定性治疗和添加系统治疗。对于有危险因素的患者，保护唾液腺尤为重要。
