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BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Risk factors for aspiration pneumonia after definitive chemoradiotherapy or bio-radiotherapy for locally advanced head and neck cancer: a monocentric case control study

Authors: Sadayuki Kawai, Tomoya Yokota, Yusuke Onozawa, Satoshi Hamauchi, Akira Fukutomi, Hirofumi Ogawa, Tsuyoshi Onoe, Tetsuro Onitsuka, Takashi Yurikusa, Akiko Todaka, Takahiro Tsushima, Yukio Yoshida, Yosuke Kito, Keita Mori, Hirofumi Yasui

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

Chemoradiotherapy (CRT) and bio-radiotherapy (BRT) are recognized as standard therapies for head and neck cancer (HNC). Aspiration pneumonia after CRT or BRT is a common late adverse event. Our aim in this study was to evaluate the cause-specific incidence of aspiration pneumonia after CRT or BRT and to identify its clinical risk factors.

Methods

We performed a retrospective analysis of 305 patients with locally advanced HNC treated by CRT or BRT between August 2006 and April 2015.

Results

Of these 305 patients, 65 (21.3%) developed aspiration pneumonia after treatment. The median onset was 161 days after treatment. The two-year cause-specific cumulative incidence by CRT or BRT was 21.0%. Multivariate analysis revealed five independent risk factors for aspiration pneumonia, namely, habitual alcoholic consumption, use of sleeping pills at the end of treatment, poor oral hygiene, hypoalbuminemia before treatment, and the coexistence of other malignancies. A predictive model using these risk factors and treatment efficacy was constructed, dividing patients into low- (0–2 predictive factors), moderate- (3–4 factors), and high-risk groups (5–6 factors), the two-year cumulative incidences of aspiration pneumonia of which were 3.0, 41.6, and 77.3%, respectively. Aspiration pneumonia tended to be associated with increased risk of death, although this was not statistically significant (multivariate-adjusted hazard ratio 1.39, P = 0.18).

Conclusion

The cause-specific incidence and clinical risk factors for aspiration pneumonia after definitive CRT or BRT were investigated in patients with locally advanced HNC. Our predictive model may be useful for identifying patients at high risk for aspiration pneumonia.
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Metadata
Title
Risk factors for aspiration pneumonia after definitive chemoradiotherapy or bio-radiotherapy for locally advanced head and neck cancer: a monocentric case control study
Authors
Sadayuki Kawai
Tomoya Yokota
Yusuke Onozawa
Satoshi Hamauchi
Akira Fukutomi
Hirofumi Ogawa
Tsuyoshi Onoe
Tetsuro Onitsuka
Takashi Yurikusa
Akiko Todaka
Takahiro Tsushima
Yukio Yoshida
Yosuke Kito
Keita Mori
Hirofumi Yasui
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3052-8

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