Background: Aspiration pneumonia (AP) is one of most important and underreported complication of chemoradiotherapy in head and neck cancer. Most patients with head and neck cancer develop mucositis & dysphagia during chemoradiation that in turn cause increased risk of aspiration and subsequent pneumonia, which can leads to prolonged hospitalization, treatment interruption or delay, morbidity and mortality. This study designed to find cause -specific incidence of AP, patient and treatment related clinical risk factors and management of AP acquired during chemoradiotherapy. Material and Methods: It is a prospective study including 84 patients of biopsy proven unresectable head and neck squamous cell carcinoma diagnosed from May 2019 to October 2020 in Tertiary care center of western India. All patients treated with curative intended chemoradiotherapy. Pneumonia acquired during chemoradiotherapy was defined as occurrence of Pneumonia within 90 days of commencement of chemoradiation. CTCAE V3.0 scale for aspiration pneumonia grading was taken. Result: Among the 84 Patients, 9 (10.71%) patients developed AP during and after treatment. Out of these 9 patients, 7 patients were hospitalized with a median length of stay 7 days. Early diagnosis and prompt use of antibiotics made possible decrease mortality in all hospitalized AP patients and rest two patients with AP developed sepsis which managed in ICU. Conclusion: Incidence of AP in HNC patients receiving radiotherapy was approximately 10.71%. Significant risk factors associated with increased risk of AP included namely age>55 years, site of tumor like laryngeal and hypopharyngeal, grade 3 dysphagia, poor oral hygiene and habitual alcohol dinking.
Narendra Kumar Gupta, Anirudh Mishra, Manish Kumar Chaturvedi, Rameshwaram Sharma. Incidence of aspiration pneumonia (AP) and associated risk factors among patients of head and neck squamous cell cancer undergoing chemoradiotherapy. International Journal of Medical and Health Research, Volume 7, Issue 3, 2021, Pages 01-05