The outcome and prognostic factors in patients with aspiration pneumonia during concurrent chemoradiotherapy for head and neck cancer

Corresponding Author

S.-W. CHEN MD

Department of Radiation Oncology, Taipei Medical University – Municipal Wan Fang Hospital; Department of Radiation Oncology, China Medical University Hospital; School of Medicine, Taipei Medical University, Taipei, Taiwan

Shang-Wen Chen, Department of Radiotherapy and Oncology, Taipei Medical University – Municipal Wan Fang Hospital, No. 111, Section 3, Hsing-Long Rd, Taipei 116, Taiwan (e-mail: [email protected]). Search for more papers by this author

S.-N. YANG MD,

S.-N. YANG MD

Department of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, Taiwan

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J.-A. LIANG MD,

J.-A. LIANG MD

Department of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, Taiwan

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F.-J. LIN MD, PHD,

F.-J. LIN MD, PHD

Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan

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S.-W. CHEN MD,

Corresponding Author

S.-W. CHEN MD

S.-N. YANG MD,

S.-N. YANG MD

Department of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, Taiwan

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J.-A. LIANG MD,

J.-A. LIANG MD

Department of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, Taiwan

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F.-J. LIN MD, PHD,

F.-J. LIN MD, PHD

Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan

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First published: 13 August 2010

https://doi.org/10.1111/j.1365-2354.2009.01104.x

Citations: 24

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Abstract

CHEN S.-W., YANG S.-N., LIANG J.-A. & LIN F.-J. (2010) European Journal of Cancer Care19, 631–635

The outcome and prognostic factors in patients with aspiration pneumonia during concurrent chemoradiotherapy for head and neck cancer

This study aimed to investigate the outcome in patients with aspiration pneumonia during definitive concurrent chemoradiotherapy for head and neck cancer. The data of 595 patients with head and neck cancer treated by chemoradiotherapy were reviewed. Forty-one patients were identified as developing symptomatic aspiration pneumonia during treatment and were analysed for this study. The definition of symptomatic aspiration pneumonia fit three criteria: (1) at least one event of aspiration during the treatment or evidence of grade 2 or above dysphagia during treatment; (2) clinical or radiographic signs of pneumonia or pneumonitis; and (3) no evidence of grade 4 haematological toxicity before the outbreak of pneumonia. Termination of allocated radiotherapy was noted in 10 patients. A treatment break was observed in 26 patients, whereas irradiation was prolonged more than 1 week in 11 patients. Logistic regression analysis showed the dysphagia score during the treatment course and the chest roentgenography pattern following symptomatic aspiration pneumonia were found to independently influence the outcome. Aspiration pneumonia occurring during chemoradiotherapy for head and neck cancer has a detrimental effect on the treatment outcome. Intensive medical care is essential for this group of patients with a dysphagia score of 3 during treatment and an unfavourable chest film pattern.

REFERENCES

Adelstein D.J., Li Y., Adams G.L., Wagner H., Jr, Kish J.A., Ensley J.F., Sculler D.E. & Forastiere A.A. (2003) An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. Journal of Clinical Oncology 21, 92–98.
10.1200/JCO.2003.01.008
PubMed Web of Science® Google Scholar
Angelis E.C., Feher O., Barros A.B.P., Nishimoto I.N. & Kowalski L.P. (2003) Voice and swallowing in patients enrolled in a larynx preservation trial. Archives of Otolaryngology–Head & Neck Surgery 129, 733–738.
10.1001/archotol.129.7.733
PubMed Web of Science® Google Scholar
Eischbrush A., Lyden T., Bradford C.R., Dawson L.A., Haxer M.J., Miller A.E., Teknos T.N., Chepeha D.B., Hogikyan N.D., Terrell J.E. & Wolf G.T. (2002) Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with head and neck cancer. International Journal of Radiation Oncology, Biology, Physics 53, 23–28.
10.1016/S0360-3016(02)02712-8
PubMed Web of Science® Google Scholar
Feng F.Y., Kim H.M., Lyden T.H., Haxer M.J., Feng M., Worden F.P., Chepeha D.B. & Eisbruch A. (2007) Intensity-modulated radiotherapy of head and neck cancer aiming to reduce dysphagia: early dose-effect relationships for the swallowing structures. International Journal of Radiation Oncology, Biology, Physics 68, 1289–1298.
10.1016/j.ijrobp.2007.02.049
PubMed Web of Science® Google Scholar
Heussel C.P., Kauczor H.U., Heussel G.E., Fischer B., Begrich M., Mildenberger P. & Thelen M. (1999) Pneumonia in febrile neutropenic patients and in bone marrow and blood stem-cell transplant recipients: use of high-resolution computed tomography. Journal of Clinical Oncology 17, 796–805.
10.1200/JCO.1999.17.3.796
CAS PubMed Web of Science® Google Scholar
Jensen K., Lambertsen K. & Grau C. (2007) Late swallowing dysfunction and dysphagia after radiotherapy for pharynx cancer: frequency, intensity and correlation with dose and volume parameters. Radiotherapy and Oncology 85, 74–82.
10.1016/j.radonc.2007.06.004
PubMed Web of Science® Google Scholar
Kotz T., Costello R., Li Y. & Posner M.R. (2004) Swallowing dysfunction after chemoradiation for advanced squamous cell carcinoma of the head and neck. Head & Neck 26, 365–372.
10.1002/hed.10385
CAS PubMed Web of Science® Google Scholar
Lazarus C.L., Logemann J.A., Pauloski B.R., Colangelo L.A., Kahrilas P.J., Mittal B.B. & Pierce M. (1996) Swallowing disorders in head and neck cancer patients treated with radiotherapy and adjuvant chemotherapy. Laryngoscope 106, 1157–1166.
10.1097/00005537-199609000-00021
CAS PubMed Web of Science® Google Scholar
Lim W.S., van der Eerden M.M., Laing R., Laing R., Boersma W.G., Karalus N., Town G.I., Lewis S.A. & Macfarlane J.T. (2003) Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax 58, 377–382.
10.1136/thorax.58.5.377
CAS PubMed Web of Science® Google Scholar
Logemann J.A., Rademaker A.W., Pauloski B.R., Lazarus C.L., Mittal B.B., Brockstein B., McCracken E., Haraf D.J., Vokes E.E., Newman L.A. & Liu D. (2006) Site of disease and treatment protocol as correlates of swallowing function in patients with head and neck cancer treated with chemoradiation. Head Neck 28, 64–73.
10.1002/hed.20299
PubMed Web of Science® Google Scholar
National Cancer Institute (NCI) (2003) Common Terminology Criteria for Adverse Events. NCI, US Department of Health and Human Services, National Institutes of Health.
Google Scholar
Nguyen N.P., Frank C., Moltz C.C., Vos P., Smith H.J., Bhamidipati P.V., Karlsson U., Nguyen P.D., Alfieri A., Nguyen L.M., Lamanski C., Chan W., Rose S. & Sallah S. (2006) Aspiration rate following chemoradiation for head and neck cancer: an underreported occurrence. Radiotherapy and Oncology 80, 302–306.
10.1016/j.radonc.2006.07.031
PubMed Web of Science® Google Scholar
Nguyen N.P., Smith H.J., Dutta S., Alfieri A., North D., Nguyen P.D., Lee H., Martinez T., Lemanski C., Ludin A., Nguyen L.M. & Sallah S. (2007) Aspiration occurrence during chemotherapy for head and neck cancer. Anticancer Research 27, 1669–1672.
PubMed Web of Science® Google Scholar
Rosenthal D.I., Lewin J.S. & Eisbrush A. (2006) Prevention and treatment of dysphagia and aspiration after chemoradiation for head and neck cancer. Journal of Clinical Oncology 24, 2636–2643.
10.1200/JCO.2006.06.0079
PubMed Web of Science® Google Scholar
Smith R.V., Goldman S.Y., Beiter J.J. & Wadler S.S. (2004) Decreased short- and long-term swallowing problems with altered radiotherapy dosing used in an organ-sparing protocol for advanced pharyngeal carcinoma. Archives of Otolaryngology–Head & Neck Surgery 130, 831–836.
10.1001/archotol.130.7.831
PubMed Web of Science® Google Scholar
Smith R.V., Kotz T., Beitler J.J. & Wadler S. (2000) Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea. Archives of Otolaryngology–Head & Neck Surgery 126, 384–389.
10.1001/archotol.126.3.384
CAS PubMed Web of Science® Google Scholar
Wither H.R., Taylor J.M.G. & Maciejewski B. (1988) The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncologica 27, 131–146.
Google Scholar

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The outcome and prognostic factors in patients with aspiration pneumonia during concurrent chemoradiotherapy for head and neck cancer

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