Infectious Complications in Patients Receiving Superselective Intra-Arterial Chemoradiotherapy for Oral Squamous Cell Carcinoma.

OBJECTIVE

Superselective intra-arterial chemoradiotherapy (IACRT) is a radical treatment performed to preserve function in patients with oral cancer. However, the characteristics of infectious complications in this patient population and the prognostic impact remain unclear.

METHODS

We retrospectively reviewed 245 consecutive patients who underwent IACRT from 2008 to 2016. The characteristics of those who developed infectious complications during IACRT were compared with those who did not.

RESULTS

One hundred eighty-four infectious complications occurred during IACRT in 133/245 (54%) patients, including intra-arterial catheter site infection (19.0%, 2.7/1000 catheter-days), central line- and peripheral catheter-associated bloodstream infection (8.7%), febrile neutropenia (16.3%), pneumonia (8.7%), Clostridioides difficile infection (8.7%) and fever of unknown origin (26.6%). Multivariate regression analysis revealed that central venous catheter placement (adjusted odds ratio: 1.42) and Grade 3/4 neutropenia (adjusted odds ratio: 1.23) were significantly associated with infectious complications. Patients with infectious complications during IACRT had a worse prognosis than those without, with 5-year overall survival rates of 66.2% and 79.4%, respectively.

CONCLUSIONS

Infectious complications during IACRT interrupt the course of cancer treatment, worsening prognosis. Thus, close monitoring and infection prevention measures are suggested to improve prognosis in patients with oral cancer undergoing IACRT.