Associated factors for tracheostomy dependence in advanced hypopharyngeal cancer with (chemo) radiation ปัจจัยที่สัมพันธ์กับการเจาะคอในมะเร็งช่องคอส่วนล่างระยะลุกลามที่รักษาด้วยรังสี รักษาหรือร่วมกับเคมีบ าบัด
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Abstract
Abstract
Objective: To study and compare factors associated with tracheostomy in locally advanced hypopharyngeal cancer patients treated with radiation therapy or concurrent chemoradiotherapy
Study design: This is a retrospective cohort analytic study conducted at Maharat Nakhon Ratchasima Hospital from January1, 2010, to December 31, 2022. A total of 131 patients with locally advanced hypopharyngeal cancer who underwent radiation therapy or concurrent chemoradiotherapy were included. The survival rate after tracheostomy was analyzed using Kaplan-Meier survival curves and Log-rank tests. Factors associated with the 1 -year tracheostomy-free rate were analyzed using Cox regression analysis, presenting Hazard ratios and 95% confidence intervals.
Results: Among the 131 patients, 34 (25.95%) required tracheostomy. The average patient follow-up is 91.1 individuals over one year. The tracheostomy rate is 3.1% during the 1-year follow-up period. The majority were male (93.1%), smokers (70.9%), and had tumors located in the pyriform sinus (77.8%). Factors significantly associated with tracheostomy included vocal cord immobility
(adjusted hazard ratio 46.69, 95% CI 6.27-347.47; p < 0.001), feeding tubes insertion during treatment (adjusted hazard ratio 4.44, 95% CI 1.83-10.77; p < 0.001), and palliative radiation therapy (adjusted hazard ratio 3.6, 95% CI 1.07-12.17; p = 0.039). The 1-year survival
tracheostomy-free rate was 64.3%, with an increasing trend in tracheostomy rate observed after 8 months.
Conclusion: In locally advanced hypopharyngeal cancer treated with radiation therapy or concurrent chemoradiotherapy, the 1-year tracheostomy-free rate was 64.3%, with an increasing trend in tracheostomy rates observed after 8 months. Factors significantly associated with tracheostomy included vocal cord immobility, feeding tube insertion during treatment, and palliative radiation
therapy, indicating statistically significant increase in tracheostomy risk.
Keywords: Malignant neoplasm of hypopharynx, tracheostomy dependence
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ต้นฉบับที่ส่งมาพิจารณายังวารสารหู คอ จมูก และใบหน้า จะต้องไม่อยู่ในการพิจารณาของวารสารอื่น ในขณะเดียวกันต้นฉบับที่จะส่งมาจะผ่านการอ่านโดยผู้ทรงคุณวุฒิ หากมีการวิจารณ์หรือแก้ไขจะส่งกลับไปให้ผู้เขียนตรวจสอบแก้ไขอีกครั้ง ต้นฉบับที่ผ่านการพิจารณาให้ลงตีพิมพ์ถือเป็นสมบัติของวารสารหู คอ จมูกและใบหน้า ไม่อาจนำไปลงตีพิมพ์ที่อื่นโดยไม่ได้รับอนุญาต
ตารางแผนภูมิ รูปภาพ หรือข้อความเกิน 100 คำที่คัดลอกมาจากบทความของผู้อื่น จะต้องมีใบยินยอมจากผู้เขียนหรือผู้ทรงลิขสิทธิ์นั้นๆ และใหร้ะบุกำกับไว้ในเนื้อเรื่องด้วย
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