# Prognosis of Pneumonia in Head and Neck Squamous Cell Carcinoma Patients Who Received Concurrent Chemoradiotherapy

## TL;DR

Pneumonia is a serious complication in head and neck cancer patients undergoing chemoradiotherapy, significantly reducing survival and linked to factors like diabetes and treatment delays.

## Contribution

The study identifies specific risk factors for pneumonia in HNSCC patients undergoing CCRT and their impact on survival outcomes.

## Key findings

- Pneumonia occurred in 23.01% of HNSCC patients undergoing CCRT, with significantly lower median overall survival (1.2 years vs. 4.9 years).
- Risk factors included diabetes mellitus, alcohol consumption, gastrostomy, and treatment delays.
- Early interventions based on these risk factors may reduce pneumonia-related complications.

## Abstract

Concurrent chemoradiotherapy (CCRT) is the standard treatment for patients with locally advanced squamous cell carcinoma of the head and neck (HNSCC). Pneumonia is a significant complication in these patients. This study aims to identify pneumonia risk factors and their impact on survival in HNSCC patients undergoing CCRT. Data from the Chang Gung Research Database (CGRD) were retrospectively reviewed for patients treated between January 2007 and December 2019. Of 6959 patients, 1601 (23.01%) developed pneumonia, resulting in a median overall survival (OS) of 1.2 years compared to 4.9 years in the non-pneumonia group (p < 0.001). The pneumonia group included older patients with advanced tumors, more patients with diabetes mellitus (DM), more patients with invasive procedures, longer chemotherapy and radiotherapy durations, and lower body weight. The 2-year, 5-year, and 10-year OS rates were significantly lower in the pneumonia group. Multivariate analysis identified alcohol consumption, DM, gastrostomy, nasogastric tube use, longer chemotherapy, and a 2-week radiotherapy delay as independent risk factors. Understanding these risks can lead to early interventions to prevent severe pneumonia-related complications. A better understanding of the risks of pneumonia enables early and aggressive interventions to prevent severe complications.