Aspiration pneumonitis following bioradiotherapy for head and neck cancer

Objective: Severe mucositis during bioradiotherapy (BRT) with Cetuximab for locally advanced squamous cell carcinoma of the head and neck(LA-SCCHN) sometimes causes interruption of the treatment. The aim of this study was to evaluate the pattern of dysphagia following BRT. Materials and Methods: This retrospective study included 21 patients with BRT and 19 patients with CDDPRT following induction chemotherapy (ICT) as an initial treatment from April 2009 to March 2016. We examined the frequency and risk factors of aspiration pneumonia. Results: During BRT, aspiration was observed in the descending stage of the larynx and it occurred more frequently in LA-SCCHN compared to that in early stages. Aspiration as an acute adverse event was more common in the BRT treated group than in the CDDP-RT treated group following ICT. However, dysphagia as late toxicity tended to be higher in the CDDP-RT treated group than in the BRT treated group following ICT. Further, many BRT treated patients experienced aspiration at an earlier time of the treatment, compared to CDDP-RT treated patients. Conclusion: When selecting BRT for LA-SCCHN, it is important to pay attention to aspiration pneumonia as an acute adverse event.