{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T22:28:53Z","timestamp":1773872933237,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T00:00:00Z","timestamp":1631059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There are limited data from low\u2010 to middle\u2010income countries (LMIC) on the incidence, risk factors, treatment outcomes, and antibiotic susceptibility spectrum of aspiration pneumonia (AsP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a post hoc analysis of a randomized control trial in which adult patients with locally advanced head and neck cancers had received 66\u201370\u00a0Gy of radiation combined with cisplatin 30\u00a0mg\/m<jats:sup>2<\/jats:sup>weekly for 6\u20137\u00a0weeks or cisplatin at the same dose with nimotuzumab 200\u00a0mg once weekly till the completion of radiation. The following data were extracted and analyzed\u2014the incidence of AsP, time to the onset of AsP, risk factors, treatment outcomes of AsP, and its impact on progression\u2010free survival (PFS), locoregional control (LRC) rates, and overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 536 patients enrolled in the study, 151 (28.3%, 95% confidence interval [CI] 24.5\u20132.1) patients developed AsP. The median time to develop AsP was 39\u00a0days (95% CI 34\u201344). Only baseline dysphagia (odds ratio\u00a0=\u00a03.76, 95% CI 1.05\u201313.51,<jats:italic>p<\/jats:italic>\u00a0=\u00a00.042) was associated with a significant risk of development of AsP. Among the patients in which pathogenic organism was isolated (69 patients), gram\u2010negative species was isolated in 63 patients (89%). Cisplatin at 200 mg\/m<jats:sup>2<\/jats:sup>or more was delivered in 312 (81%) patients in the non\u2010AsP cohort versus 107 (70.9%) patients in AsP cohort (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.014). There was no statistical difference in LRC (hazard ratio [HR]\u00a0=\u00a01.057; 95% CI 0.771\u20131.448), PFS (HR\u00a0=\u00a01.176; 95% CI 0.89\u20131.553), and OS (HR\u00a0=\u00a01.233; 95% CI 0.939\u20131.618) between the two cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Aspiration pneumonia is a common complication in head and neck malignancies and patients with baseline dysphagia are at high risk. Gram\u2010negative bacteria are the predominant causative agents. The use of broad\u2010spectrum antibiotics results in resolution of symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4210","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T00:38:37Z","timestamp":1631147917000},"page":"6725-6735","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Aspiration pneumonia in head and neck cancer patients undergoing concurrent chemoradiation from India: Findings from a post hoc analysis of a phase 3 study"],"prefix":"10.1002","volume":"10","author":[{"given":"Vijay","family":"Patil","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Centre HBNI Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanita","family":"Noronha","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Centre HBNI Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Shrirangwar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Centre HBNI Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4214-5799","authenticated-orcid":false,"given":"Nandini","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Centre HBNI Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9425-1262","authenticated-orcid":false,"given":"George","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Centre HBNI Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5373-0558","authenticated-orcid":false,"given":"Arun","family":"Chandrasekharan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Centre HBNI Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8858-5004","authenticated-orcid":false,"given":"Kumar","family":"Prabhash","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Centre HBNI Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29210"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(90)90294-3"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-020-6682-1"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215115001450"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.08.015"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2019.02.013"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29207"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2016.03.014"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016489.2015.1113439"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-017-3052-8"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25412"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2012.742205"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26314"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4103\/CRST.CRST_15_18","article-title":"Once\u2010a\u2010week versus once\u2010every\u20103\u2010weeks cisplatin in patients receiving chemoradiation for locally advanced head\u2010and\u2010neck cancer: a survey of practice in India","volume":"1","author":"Goyal G","year":"2018","journal-title":"Cancer Res Stat Treat"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32179"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820938011"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940911801111"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.124776"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.13.1393"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2354.2009.01104.x"},{"key":"e_1_2_10_22_1","unstructured":"User S. 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