Kao Tzu-Hsun, Chiu Tai-Jan, Wu Ching-Nung, Wu Shao-Chun, Chen Wei-Chih, Yang Yao-Hsu, Wang Yu-Ming, Luo Sheng-Dean
Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
Biomedicines. 2024 Jul 4;12(7):1480. doi: 10.3390/biomedicines12071480.
Concurrent chemoradiotherapy (CCRT) is the standard treatment for patients with locally advanced squamous cell carcinoma of the head and neck (HNSCC). Pneumonia is a significant complication in these patients. This study aims to identify pneumonia risk factors and their impact on survival in HNSCC patients undergoing CCRT. Data from the Chang Gung Research Database (CGRD) were retrospectively reviewed for patients treated between January 2007 and December 2019. Of 6959 patients, 1601 (23.01%) developed pneumonia, resulting in a median overall survival (OS) of 1.2 years compared to 4.9 years in the non-pneumonia group ( < 0.001). The pneumonia group included older patients with advanced tumors, more patients with diabetes mellitus (DM), more patients with invasive procedures, longer chemotherapy and radiotherapy durations, and lower body weight. The 2-year, 5-year, and 10-year OS rates were significantly lower in the pneumonia group. Multivariate analysis identified alcohol consumption, DM, gastrostomy, nasogastric tube use, longer chemotherapy, and a 2-week radiotherapy delay as independent risk factors. Understanding these risks can lead to early interventions to prevent severe pneumonia-related complications. A better understanding of the risks of pneumonia enables early and aggressive interventions to prevent severe complications.
同步放化疗(CCRT)是局部晚期头颈部鳞状细胞癌(HNSCC)患者的标准治疗方法。肺炎是这些患者的一种重要并发症。本研究旨在确定HNSCC患者接受CCRT时的肺炎危险因素及其对生存的影响。回顾性分析了长庚研究数据库(CGRD)中2007年1月至2019年12月期间接受治疗的患者数据。在6959例患者中,1601例(23.01%)发生了肺炎,肺炎组的中位总生存期(OS)为1.2年,而非肺炎组为4.9年(P<0.001)。肺炎组包括年龄较大、肿瘤晚期的患者,更多患有糖尿病(DM)的患者,更多接受侵入性操作的患者,化疗和放疗时间更长,以及体重更低的患者。肺炎组的2年、5年和10年OS率显著更低。多因素分析确定饮酒、DM、胃造瘘术、鼻胃管使用、更长的化疗时间以及放疗延迟2周为独立危险因素。了解这些风险可促使进行早期干预以预防严重的肺炎相关并发症。更好地了解肺炎风险能够进行早期积极干预以预防严重并发症。