BACKGROUND AND PURPOSE: Many head and neck cancer (HNC) survivors experience diminished quality of life due to radiation-induced dysphagia. The aim of this study was to investigate frequency, intensity and dose-volume dependency for late dysphagia in HNC patients treated with curative IMRT. MATERIALS AND METHODS: Candidates for the study were 294 patients treated with primary IMRT from 2006 to 2010; a total of 259 patients accepted to participate by answering the EORTC QLQ-C30 and H&N35 questionnaires. A total of 65 patients were further examined with modified barium swallow (MBS) and saliva collection. Data on patient, tumor and treatment characteristics were prospectively recorded in the DAHANCA database. Dose-volume histograms (DVH) of swallowing-related structures were retrospectively analyzed. RESULTS: QoL data showed low degree of dysphagia (QoL subscales scores of 17 and below) compared to objective measures. The most frequent swallowing dysfunction was retention; penetration and aspiration was less common. In general, objective measurements and observer-assessed late dysphagia correlated with dose to pharyngeal constrictor muscles (PCM), whereas QoL endpoints correlated with DVH parameters in the glottis/supraglottic larynx. Both xerostomia and dysphagia has been reduced after introduction of IMRT. CONCLUSIONS: Radiation-induced dysphagia is still important, with a high degree of retention and penetration. Introduction of parotid-sparing IMRT has reduced the severity of dysphagia, primarily through a major reduction in xerostomia. Dose-response relationships were found for specific dysphagia endpoints.
BACKGROUND AND PURPOSE: Many head and neck cancer (HNC) survivors experience diminished quality of life due to radiation-induced dysphagia. The aim of this study was to investigate frequency, intensity and dose-volume dependency for late dysphagia in HNCpatients treated with curative IMRT. MATERIALS AND METHODS: Candidates for the study were 294 patients treated with primary IMRT from 2006 to 2010; a total of 259 patients accepted to participate by answering the EORTC QLQ-C30 and H&N35 questionnaires. A total of 65 patients were further examined with modified barium swallow (MBS) and saliva collection. Data on patient, tumor and treatment characteristics were prospectively recorded in the DAHANCA database. Dose-volume histograms (DVH) of swallowing-related structures were retrospectively analyzed. RESULTS: QoL data showed low degree of dysphagia (QoL subscales scores of 17 and below) compared to objective measures. The most frequent swallowing dysfunction was retention; penetration and aspiration was less common. In general, objective measurements and observer-assessed late dysphagia correlated with dose to pharyngeal constrictor muscles (PCM), whereas QoL endpoints correlated with DVH parameters in the glottis/supraglottic larynx. Both xerostomia and dysphagia has been reduced after introduction of IMRT. CONCLUSIONS: Radiation-induced dysphagia is still important, with a high degree of retention and penetration. Introduction of parotid-sparing IMRT has reduced the severity of dysphagia, primarily through a major reduction in xerostomia. Dose-response relationships were found for specific dysphagia endpoints.
Authors: Jeffrey M Vainshtein; Dominic H Moon; Felix Y Feng; Douglas B Chepeha; Avraham Eisbruch; Matthew H Stenmark Journal: Int J Radiat Oncol Biol Phys Date: 2015-04-01 Impact factor: 7.038
Authors: Molly K Barnhart; Elizabeth C Ward; Bena Cartmill; Rachelle A Robinson; Virginia A Simms; Sophie J Chandler; Elea T Wurth; Robert I Smee Journal: Eur Arch Otorhinolaryngol Date: 2016-08-06 Impact factor: 2.503
Authors: Christopher R Spencer; Hiram A Gay; Bruce H Haughey; Brian Nussenbaum; Douglas R Adkins; Tanya M Wildes; Todd A DeWees; James S Lewis; Wade L Thorstad Journal: Cancer Date: 2014-08-20 Impact factor: 6.860
Authors: R Mazzola; F Ricchetti; A Fiorentino; S Fersino; N Giaj Levra; S Naccarato; G Sicignano; S Albanese; G Di Paola; D Alterio; R Ruggieri; F Alongi Journal: Br J Radiol Date: 2014-10-28 Impact factor: 3.039