Examination of elderly hypopharyngeal cancer cases at our hospital-especially pneumonia-

Author(s)：

Yukinori Asada¹, Takayuki Imai¹, Tomoko Yamazaki², Satoshi Saijo¹, Keitarou Fujii¹, Akira Nakazato¹, Kazuki Nakamura¹, Yuya Miyakura¹

Affiliation(s)：

¹head and Neck Surgery, Miyagi Cancer Center, ²Head and Neck Oncology, Miyagi Cancer Center

Introduction: The treatment of head and neck cancer, especially (chemo) radiation therapy ((C)RT) and increased risk of aspiration pneumonia, has long been discussed. According to a study by Xu et al., More than 20% of patients with head and neck cancer treated by CRT reported to have aspiration pneumonia, among which hypopharyngeal cancer, nasopharyngeal cancer and Age (elderly) is listed as a risk factor. Therefore, we examined treatment options and pneumonia in elderly patients with hypopharyngeal cancer who received first line treatment at our hospital. Method: We investigated cases of hypopharyngeal cancer aged 75 years or older who received first line treatment at our hospital from January 2000 to March 2020. Then, the group aged 7579 and the group aged 80 and over were compared and examined. Results: There were a total of 111 cases of hypopharyngeal cancer (39 cases over 80 years old, 72 cases 7579 years old). There were 34 cases who received (C)RT as a treatment option, 22 cases palliative treatment, 55 cases who received surgical treatment, and 26 cases of laryngeal preservation surgery. In the group over 80 years old, the ratio of palliative choices was high. The incidence of pneumonia was significantly higher in the group aged 80 years and older than in the group aged 75 to 79 years in all cases treated with curative treatment. Examining the cases treated with C) RT, the number of cases with Grade 3 or higher aspiration pneumonia within 1 year was 1 in 23in the 75-79 year-old group.But in the group aged 80 years and older, pneumonia was observed in 6 of 12 cases, and 2 of them had disappeared.When the risk of pneumonia was examined by age in patients who received (C)RT therapy, it was shown that the risk of pneumonia was significantly higher in the group aged 80 years or older. Conclusion: Radiation therapy for hypopharyngeal cancer cases over 80 years old should be considered.