Volume 36, Issue 1 pp. 120-125

Original Article

Aspiration pneumonia after chemo–intensity-modulated radiation therapy of oropharyngeal carcinoma and its clinical and dysphagia-related predictors

Klaudia U. Hunter MD,

Klaudia U. Hunter MD

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

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Oliver E. Lee PhD,

Oliver E. Lee PhD

Department of Biostatistics, University of Michigan, Ann Arbor, Michigan

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Teresa H. Lyden MA,

Teresa H. Lyden MA

Department of Speech–Language Pathology, University of Michigan, Ann Arbor, Michigan

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Marc J. Haxer MA,

Marc J. Haxer MA

Department of Speech–Language Pathology, University of Michigan, Ann Arbor, Michigan

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Felix Y. Feng MD,

Felix Y. Feng MD

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

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Mathew Schipper PhD,

Mathew Schipper PhD

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

Department of Biostatistics, University of Michigan, Ann Arbor, Michigan

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Francis Worden MD,

Francis Worden MD

Department of Medicine–Hematology–Oncology, University of Michigan, Ann Arbor, Michigan

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Mark E. Prince MD,

Mark E. Prince MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

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Scott A. McLean MD,

Scott A. McLean MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

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Gregory T. Wolf MD,

Gregory T. Wolf MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

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Carol R. Bradford MD,

Carol R. Bradford MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

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Douglas B. Chepeha MD,

Douglas B. Chepeha MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

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Avraham Eisbruch MD,

Corresponding Author

Avraham Eisbruch MD

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

Department of Radiation Oncology, 1500 E. Medical Center Drive, UH B@C490 SPC 5010, Ann Arbor MI 48109. E-mail: [email protected]Search for more papers by this author

Klaudia U. Hunter MD,

Klaudia U. Hunter MD

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Oliver E. Lee PhD,

Oliver E. Lee PhD

Department of Biostatistics, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Teresa H. Lyden MA,

Teresa H. Lyden MA

Department of Speech–Language Pathology, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Marc J. Haxer MA,

Marc J. Haxer MA

Department of Speech–Language Pathology, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Felix Y. Feng MD,

Felix Y. Feng MD

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Mathew Schipper PhD,

Mathew Schipper PhD

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

Department of Biostatistics, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Francis Worden MD,

Francis Worden MD

Department of Medicine–Hematology–Oncology, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Mark E. Prince MD,

Mark E. Prince MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Scott A. McLean MD,

Scott A. McLean MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Gregory T. Wolf MD,

Gregory T. Wolf MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Carol R. Bradford MD,

Carol R. Bradford MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Douglas B. Chepeha MD,

Douglas B. Chepeha MD

Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan

Search for more papers by this author

Avraham Eisbruch MD,

Corresponding Author

Avraham Eisbruch MD

Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan

Department of Radiation Oncology, 1500 E. Medical Center Drive, UH B@C490 SPC 5010, Ann Arbor MI 48109. E-mail: [email protected]Search for more papers by this author

First published: 01 June 2013

https://doi.org/10.1002/hed.23275

Citations: 90

This work was presented in part at the 8th International Conference on Head and Neck Cancer, Toronto, Canada, July 21–25, 2012.

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Abstract

Background

The purpose of this study was to assess aspiration pneumonia (AsPn) rates and predictors after chemo-irradiation for head and neck cancer.

Methods

The was a prospective study of 72 patients with stage III to IV oropharyngeal cancer treated definitively with intensity-modulated radiotherapy (IMRT) concurrent with weekly carboplatin and paclitaxel. AsPn was recorded prospectively and dysphagia was evaluated longitudinally through 2 years posttherapy by observer-rated (Common Toxicity Criteria version [CTCAE]) scores, patient-reported scores, and videofluoroscopy.

Results

Sixteen patients (20%) developed AsPn. Predictive factors included T classification (p = .01), aspiration detected on videofluoroscopy (videofluoroscopy-asp; p = .0007), and patient-reported dysphagia (p = .02–.0003), but not observer-rated dysphagia (p = .4). Combining T classification, patient reported dysphagia, and videofluoroscopy-asp, provided the best predictive model.

Conclusion

AsPn continues to be an under-reported consequence of chemo-irradiation for head and neck cancer. These data support using patient-reported dysphagia to identify high-risk patients requiring videofluoroscopy evaluation for preventive measures. Reducing videofluoroscopy-asp rates, by reducing swallowing structures radiation doses and by trials reducing treatment intensity in patients predicted to do well, are likely to reduce AsPn rates. © 2013 Wiley Periodicals, Inc. Head Neck 36: 120–125, 2014

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Citing Literature

Volume36, Issue1

January 2014

Pages 120-125

Aspiration pneumonia after chemo–intensity-modulated radiation therapy of oropharyngeal carcinoma and its clinical and dysphagia-related predictors

Abstract

Background

Methods

Results

Conclusion

REFERENCES

Citing Literature

References

Information

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Aspiration pneumonia after chemo–intensity-modulated radiation therapy of oropharyngeal carcinoma and its clinical and dysphagia-related predictors

Abstract

Background

Methods

Results

Conclusion

REFERENCES

Citing Literature

References

Related

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