Prognostic Factors of Flap Complications After Carbon-ion Radiotherapy for Head and Neck Cancer With Reconstruction.

IF 1.6 4区 医学 Q4 ONCOLOGY
Hiroaki Ikawa, Masashi Koto, Tokuhiko Omatsu, Shuri Aoki, Hirotoshi Takiyama, Tetsuro Isozaki, Makoto Shinoto, Reiko Imai, Hiroshi Tsuji, Shigeru Yamada
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引用次数: 0

Abstract

Background/aim: The incidence of flap complications after carbon-ion (C-ion) radiotherapy (RT) for head and neck cancer with reconstruction is unknown. This study investigated the incidence and risk factors of flap complications following C-ion RT for head and neck cancer with reconstruction.

Patients and methods: We retrospectively analyzed 24 cases, excluding cases of re-irradiation, treated with C-ion RT at QST Hospital for loco-regional recurrence after reconstructive surgery for head and neck cancers from April 1997 to March 2020. We evaluated flap complications as anastomosis-related (flap loss and necrosis) and flap bed-related (wound dehiscence) complications. Wound dehiscence was assessed using Common Terminology Criteria for Adverse Events version 5.0. The correlation between clinical factors, dosimetric parameters, and flap complication was analyzed retrospectively.

Results: The median follow-up period was 42.2 months (range=6.7-155.9 months). None of the 24 enrolled patients experienced flap loss and flap necrosis, and two (8.3%) patients had grade 1 wound dehiscence; grade 2 or greater toxicities were not recorded. The median interval between C-ion RT and wound dehiscence of the flap was 6.8 (6.5 and 7.0) months. Univariate analysis to identify clinical and dose-volume histogram parameters associated with the occurrence of grade 1 wound dehiscence after C-ion RT revealed that the minimum dose (Dmin) ≥5.9 Gy for flap was a statistically significant risk factor (p=0.017).

Conclusion: C-ion RT for head and neck cancers after reconstructive surgery is safe, with no serious flap complications. Dmin was an independent risk factor for the development of wound dehiscence.

头颈癌碳离子放疗重建后皮瓣并发症的预后因素分析。
背景/目的:碳离子(C-ion)放射治疗头颈癌重建后皮瓣并发症的发生率尚不清楚。本研究探讨c离子RT治疗头颈癌再造术后皮瓣并发症的发生率及危险因素。患者和方法:我们回顾性分析了1997年4月至2020年3月在QST医院接受c离子放疗治疗头颈癌重建术后局部复发的24例病例,不包括再照射病例。我们评估皮瓣并发症为吻合相关(皮瓣丢失和坏死)和皮瓣床相关(伤口开裂)并发症。伤口开裂采用不良事件通用术语标准5.0版进行评估。回顾性分析临床因素、剂量学参数与皮瓣并发症的相关性。结果:中位随访时间为42.2个月(范围6.7 ~ 155.9个月)。24例入组患者均未出现皮瓣丢失和皮瓣坏死,2例(8.3%)患者出现1级创面裂开;2级或以上的毒性未被记录。c离子RT到皮瓣创面破裂的中位时间间隔为6.8个月(6.5个月和7.0个月)。对c离子RT术后发生1级创面裂开的临床及剂量-体积直方图参数进行单因素分析发现,皮瓣最小剂量(Dmin)≥5.9 Gy是具有统计学意义的危险因素(p=0.017)。结论:c离子RT治疗头颈部肿瘤重建术后安全,无严重皮瓣并发症。Dmin是创面裂开发生的独立危险因素。
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来源期刊
Anticancer research
Anticancer research 医学-肿瘤学
CiteScore
3.70
自引率
10.00%
发文量
566
审稿时长
2 months
期刊介绍: ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.
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