title: Risk of swallowing-related chest infections in patients with nasopharyngeal carcinoma treated with definitive intensity-modulated radiotherapy.
abstract: Pulmonary complications secondary to dysphagia may be encountered in patients with nasopharyngeal carcinoma (NPC) after definitive intensity-modulated radiotherapy. The purpose of this study was to identify patients with NPC at risk of developing swallowing-related chest infections (SRCIs).
  
  
  
  Retrospective chart review was performed on 217 patients with stage I to IVB NPC treated definitively with radiotherapy or chemoradiotherapy.
  
  
  
  Twenty-six patients (12.0%) developed SRCIs; 4 of these patients (15.3%) required intensive care unit (ICU) admission and 9 (34.6%) died of the complication. The median time interval between completions of radiotherapy to the development of SRCIs was 24.5 months. Advanced age, recurrent disease, and concurrent chemoradiotherapy were significantly associated with the development of SRCIs in the multivariable analysis.
  
  
  
  SRCI is a common and potentially fatal complication for postirradiated patients with NPC. Advanced age, concurrent chemoradiotherapy, and recurrent cancer were strong risk factors for postirradiated patients with NPC to develop SRCIs. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1660-E1665, 2016.
authors.affiliation: Duke-NUS Graduate Medical School, Singapore.
authors.forename: Jiaqing
authors.initials: J
authors.lastname: Xiong
authors.affiliation: Duke-NUS Graduate Medical School, Singapore.
authors.forename: Gita
authors.initials: G
authors.lastname: Krishnaswamy
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore.
authors.forename: Sharon
authors.initials: S
authors.lastname: Raynor
authors.affiliation: Department of Infectious Disease, Duke-NUS Medical School, Singapore.
authors.forename: Kwok Seng
authors.initials: KS
authors.lastname: Loh
authors.affiliation: Duke-NUS Graduate Medical School, Singapore.|Department of Infectious Disease, Duke-NUS Medical School, Singapore.
authors.forename: Andrea Lay Hoon
authors.initials: AL
authors.lastname: Kwa
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore.
authors.forename: Chwee Ming
authors.initials: CM
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000532:radiotherapy*; D003679:Deglutition; D003680:Deglutition Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D015995:Prevalence; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: aspiration pneumonia; chest infections; dysphagia; intensity-modulated radiotherapy; nasopharyngeal carcinoma