title: Aspiration pneumonia in patients treated with radiotherapy for head and neck cancer.
abstract: Aspiration and aspiration pneumonia has been reported with a high incidence in head and neck cancer populations treated with chemo-radiotherapy. The aim of this study was to investigate the incidence and mortality of aspiration pneumonia in an unselected series of head and neck cancer patients treated with curative radiotherapy with or without concurrent weekly cisplatin.
  
  
  METHODS
  A total of 324 consecutive patients treated with curative intended radiotherapy for head and neck cancer in a single Danish referral center in Aarhus from 2006 to 2008 were included and followed for a median of 4.3 years. Data on patient, tumor and treatment characteristics were obtained from the DAHANCA database. Data on hospital admissions were obtained from the National Patient Registry. Data from the National Registry of Causes of Death were obtained on all deaths and causes of death.
  
  
  RESULTS
  Severe dysphagia occurred in 32% of the 324 patients included. A total of 18 patients developed aspiration pneumonia, corresponding to an incidence rate of 29 (95% CI 17-46) per 1000 person-years and an incidence proportion of 5.3% (95% CI 3.1-8.3%) in the first year after radiotherapy; significant risk factors included tube feeding, clinical stage, severe dysphagia and incomplete response to treatment. Three of the 18 patients with aspiration pneumonia died from this complication.
  
  
  CONCLUSIONS
  Dysphagia-related aspiration and aspiration pneumonia are serious and potentially fatal treatment complications to accelerated radiotherapy, but occur less frequent than previously reported.
authors.affiliation: Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. hanna@oncology.dk
authors.forename: Hanna R
authors.initials: HR
authors.lastname: Mortensen
authors.forename: Kenneth
authors.initials: K
authors.lastname: Jensen
authors.forename: Cai
authors.initials: C
authors.lastname: Grau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy*; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000453:epidemiology*; D011832:Radiation Injuries / Q000453:epidemiology*; D055815:Young Adult