Infectious Complications in Patients Receiving Superselective Intra-Arterial Chemoradiotherapy for Oral Squamous Cell Carcinoma.

IF 2.9 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral diseases Pub Date : 2025-07-13 DOI:10.1111/odi.70027

Hideaki Kato, Takashi Ohya, Toshiyuki Koizumi, Masaki Iida, Shoko Takano, Masaharu Hata, Hideaki Nakajima, Kenji Mitsudo

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引用次数: 0

Abstract

Objective: Superselective intra-arterial chemoradiotherapy (IACRT) is a radical treatment performed to preserve function in patients with oral cancer. However, the characteristics of infectious complications in this patient population and the prognostic impact remain unclear.

Methods: We retrospectively reviewed 245 consecutive patients who underwent IACRT from 2008 to 2016. The characteristics of those who developed infectious complications during IACRT were compared with those who did not.

Results: One hundred eighty-four infectious complications occurred during IACRT in 133/245 (54%) patients, including intra-arterial catheter site infection (19.0%, 2.7/1000 catheter-days), central line- and peripheral catheter-associated bloodstream infection (8.7%), febrile neutropenia (16.3%), pneumonia (8.7%), Clostridioides difficile infection (8.7%) and fever of unknown origin (26.6%). Multivariate regression analysis revealed that central venous catheter placement (adjusted odds ratio: 1.42) and Grade 3/4 neutropenia (adjusted odds ratio: 1.23) were significantly associated with infectious complications. Patients with infectious complications during IACRT had a worse prognosis than those without, with 5-year overall survival rates of 66.2% and 79.4%, respectively.

Conclusions: Infectious complications during IACRT interrupt the course of cancer treatment, worsening prognosis. Thus, close monitoring and infection prevention measures are suggested to improve prognosis in patients with oral cancer undergoing IACRT.

查看原文本刊更多论文

口腔鳞状细胞癌超选择性动脉内放化疗患者的感染并发症。

目的：超选择性动脉内放化疗（IACRT）是维持口腔癌患者功能的根治性治疗方法。然而，感染并发症的特点，在这一患者群体和预后影响仍不清楚。方法：我们回顾性分析了2008年至2016年连续接受IACRT的245例患者。比较IACRT期间发生感染并发症的患者和未发生感染并发症的患者的特征。结果：133/245例（54%）患者在IACRT期间发生了184例感染并发症，包括动脉导管部位感染（19.0%，2.7/1000导管日）、中心静脉和外周导管相关血流感染（8.7%）、发热性中性粒细胞减少（16.3%）、肺炎（8.7%）、艰难梭菌感染（8.7%）和不明原因发热（26.6%）。多因素回归分析显示，中心静脉置管（校正优势比：1.42）和3/4级中性粒细胞减少（校正优势比：1.23）与感染并发症显著相关。IACRT期间有感染并发症的患者预后较无感染并发症的患者差，5年总生存率分别为66.2%和79.4%。结论：IACRT期间的感染性并发症中断了肿瘤的治疗过程，使预后恶化。因此，建议密切监测和预防感染，以改善口腔癌患者行IACRT的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral diseases 医学-牙科与口腔外科

CiteScore

7.60

自引率

5.30%

发文量

325

审稿时长

4-8 weeks

期刊介绍： Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.