探索接受放化疗的局部晚期头颈部鳞状细胞癌患者中G管置管时机与临床结局。

文献信息

中文摘要

背景： 在局部头颈癌（HNSCC）接受根治性放化疗（dCRT）的患者中，G管置管时机的特征仍不明确。
方法： 我们回顾性分析了144例接受dCRT的HNSCC患者（2019-2024年），按“预先”或“按需”G管策略分类，并使用倾向评分加权探讨与置管时机及结局相关的因素。
结果： 大多数患者为白人（85%）和男性（83%）；中位年龄为63岁。预先G管置管发生于60例患者（42%），在女性（64% vs. 37%，p = 0.015）以及有吞咽困难（55% vs. 28%，p = 0.001）或接受诱导化疗（71% vs. 38%，p = 0.023）者中更常见。dCRT持续时间、体重下降、急诊就诊、住院、ICU入住和生存无差异。预先置管与化疗方案修改的几率降低（降低73%，p = 0.007）和输液门诊就诊次数更少（平均少3次，p = 0.038）相关。
结论： 这些发现提示多种因素影响G管置管时机和结局，值得前瞻性验证。

英文摘要

BACKGROUND: G-tube placement timing remains poorly characterized in patients with localized head and neck cancer (HNSCC) undergoing definitive chemoradiation (dCRT).
METHODS: We retrospectively analyzed 144 patients with HNSCC who received dCRT (2019-2024), categorized by "upfront" or "as-needed" G-tube strategy, to explore factors associated with timing and outcomes using propensity score weighting.
RESULTS: Most patients were White (85%) and male (83%); median age was 63 years. Upfront G-tube placement occurred in 60 patients (42%) and was more common among women (64% vs. 37%, p = 0.015) and those with dysphagia (55% vs. 28%, p = 0.001) or receiving induction chemotherapy (71% vs. 38%, p = 0.023). dCRT duration, weight loss, ED visits, hospitalizations, ICU admissions, and survival did not differ. Upfront placement was associated with lower odds of chemotherapy modification (73% lower, p = 0.007) and fewer infusion clinic visits (average 3 fewer, p = 0.038).
CONCLUSION: These findings suggest multiple factors influence G-tube timing and outcomes, warranting prospective validation.