BACKGROUND Prophylactic percutaneous endoscopic gastrostomy (PEG) has been widely performed before concurrent chemoradiotherapy (CCRT) for locally advanced squamous cell carcinoma of the head and neck (LASCCHN) because severe oral mucositis and dysphagia induced by CCRT lead to difficulty with oral intake. However, it is controversial whether all patients require prophylactic PEG for adjuvant CCRT. This study evaluated predictive factors for the feasibility of oral intake in adjuvant CCRT for patients with LASCCHN. METHODS This study retrospectively analyzed 117 LASCCHN patients who underwent surgery followed by adjuvant CCRT with cisplatin at Shizuoka Cancer Center between April 2008 and December 2018. To investigate predictive factors for the feasibility of oral intake, tumor factors, treatment factors and social factors were included in multivariate analyses. RESULTS Of the 117 patients, 25 received total laryngectomy and 92 received other surgery. In multivariate analysis, total laryngectomy [HR (hazard ratio) 0.09, P = 0.001] and oral cavity of primary tumor location (HR 0.21, P = 0.031) were significantly associated with the feasibility of oral intake. Difficulty obtaining adequate nutrition via oral intake from initiation of CCRT until 1 year after its completion was significantly rarer in the total laryngectomy group than in the other surgery group (16% vs. 57%, P < 0.001). CONCLUSION Our study suggests that majority of patients who underwent total laryngectomy are able to maintain oral intake during adjuvant chemoradiotherapy.

中文翻译：

---

对于局部晚期头颈部鳞状细胞癌患者，在辅助同时放化疗中口服摄入可行性的治疗前预测因素。

背景技术在局部放疗的头颈部鳞状细胞癌（LASCCHN）同时放化疗（CCRT）之前，已广泛进行了预防性经皮内镜胃造口术（PEG），因为严重的口腔粘膜炎和由CCRT引起的吞咽困难导致口服困难。然而，是否所有患者都需要辅助PEG治疗CCRT是有争议的。这项研究评估了LASCCHN患者辅助CCRT口服摄入可行性的预测因素。方法这项研究回顾了2008年4月至2018年12月在静冈癌症中心接受手术治疗并接受CCRT联合顺铂辅助治疗的117例LASCCHN患者。为了研究口服摄入可行性的预测因素，肿瘤因素，治疗因素和社会因素包括在多变量分析中。结果在117例患者中，有25例接受了全喉切除术，而92例接受了其他手术。在多变量分析中，全喉切除[HR（危险比）0.09，P = 0.001]和口腔内原发肿瘤的位置（HR 0.21，P = 0.031）与口服的可行性密切相关。从CCRT开始至完成后的1年内，通过口服摄入获取足够营养的困难在整个喉切除术组中明显少于其他手术组（16％vs. 57％，P <0.001）。结论我们的研究表明，大多数接受全喉切除术的患者在辅助放化疗期间能够保持口服摄入。25例接受了全喉切除术，而92例接受了其他手术。在多变量分析中，全喉切除[HR（危险比）0.09，P = 0.001]和口腔内原发肿瘤的位置（HR 0.21，P = 0.031）与口服的可行性密切相关。从CCRT开始至完成后的1年内，通过口服摄入获取足够营养的困难在整个喉切除术组中明显少于其他手术组（16％vs. 57％，P <0.001）。结论我们的研究表明，大多数接受全喉切除术的患者在辅助放化疗期间能够保持口服摄入。25例接受了全喉切除术，而92例接受了其他手术。在多变量分析中，全喉切除[HR（危险比）0.09，P = 0.001]和口腔内原发肿瘤的位置（HR 0.21，P = 0.031）与口服的可行性密切相关。从CCRT开始至完成后的1年内，通过口服摄入获取足够营养的困难在整个喉切除术组中明显少于其他手术组（16％vs. 57％，P <0.001）。结论我们的研究表明，大多数接受全喉切除术的患者在辅助放化疗期间能够保持口服摄入。031）与口服的可行性显着相关。从CCRT开始至完成后的1年内，通过口服摄入获取足够营养的困难在整个喉切除术组中明显少于其他手术组（16％vs. 57％，P <0.001）。结论我们的研究表明，大多数接受全喉切除术的患者在辅助放化疗期间能够保持口服摄入。031）与口服的可行性显着相关。从CCRT开始至完成后的1年内，通过口服摄入获取足够营养的困难在整个喉切除术组中明显少于其他手术组（16％vs. 57％，P <0.001）。结论我们的研究表明，大多数接受全喉切除术的患者在辅助放化疗期间能够保持口服摄入。