Prognosis of Pneumonia in Head and Neck Squamous Cell Carcinoma Patients Who Received Concurrent Chemoradiotherapy.
Tzu-Hsun KaoTai-Jan ChiuChing-Nung WuCheuk-Kwan SunWei-Chih ChenYao-Hsu YangYu-Ming WangSheng-Dean LuoPublished in: Biomedicines (2024)
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 ( p < 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.
Keyphrases
- locally advanced
- squamous cell carcinoma
- rectal cancer
- risk factors
- neoadjuvant chemotherapy
- radiation therapy
- phase ii study
- respiratory failure
- community acquired pneumonia
- end stage renal disease
- patients undergoing
- body weight
- physical activity
- ejection fraction
- emergency department
- type diabetes
- clinical trial
- alcohol consumption
- randomized controlled trial
- early onset
- radiation induced
- adipose tissue
- intensive care unit
- patient reported outcomes
- machine learning
- drug induced
- middle aged
- glycemic control
- patient reported
- study protocol