Angela T T Wong1, Stephen Y Lai2, G Brandon Gunn3, Beth M Beadle3, Clifton D Fuller3, Martha P Barrow1, Theresa M Hofstede1, Mark S Chambers1, Erich M Sturgis1, Abdallah Sherif Radwan Mohamed3, Jan S Lewin1, Katherine A Hutcheson4. 1. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 2. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Molecular and Cellular Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 3. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: karnold@mdanderson.org.
Abstract
OBJECTIVE: The purpose is to examine the relationship between mandibular osteoradionecrosis (ORN) and chronic dysphagia in long-term oropharynx cancer (OPC) survivors, and to determine the perceived symptom burden associated with ORN. MATERIALS AND METHODS: Medical records of 349 OPC patients treated with bilateral IMRT and systemic therapy were reviewed. ORN was graded using a published 4-point classification schema. Patients were considered to have chronic dysphagia if they had aspiration pneumonia, stricture or aspiration detected by fluoroscopy or endoscopy, and/or feeding tube dependence in long-term follow-up ⩾1year following radiotherapy. MD Anderson Symptom Inventory - Head and Neck Module (MDASI-HN) scores were analyzed in a nested cross-sectional survey sample of 118 patients. RESULTS: 34 (9.7%, 95% CI: 6.8-13.3%) patients developed ORN and 45 (12.9%, 95% CI: 9.6-16.9%) patients developed chronic dysphagia. Prevalence of chronic dysphagia was significantly higher in ORN cases (12/34, 35%) compared to those who did not develop ORN (33/315, 11%, p<0.001). ORN grade was also significantly associated with prevalence of dysphagia (p<0.001); the majority of patients with grade 4 ORN requiring major surgery (6 patients, 75%) were found to have chronic dysphagia. Summary MDASI-HN symptom scores did not significantly differ by ORN grade. Significantly higher symptom burden was reported, however, among ORN cases compared to those without ORN for MDASI-HN swallowing (p=0.033), problems with teeth and/or gums (p=0.016) and change in activity (p=0.015) item scores. CONCLUSIONS: ORN is associated with excess burden of chronic dysphagia and higher symptom severity related to swallowing, dentition and activity limitations.
OBJECTIVE: The purpose is to examine the relationship between mandibular osteoradionecrosis (ORN) and chronic dysphagia in long-term oropharynx cancer (OPC) survivors, and to determine the perceived symptom burden associated with ORN. MATERIALS AND METHODS: Medical records of 349 OPCpatients treated with bilateral IMRT and systemic therapy were reviewed. ORN was graded using a published 4-point classification schema. Patients were considered to have chronic dysphagia if they had aspiration pneumonia, stricture or aspiration detected by fluoroscopy or endoscopy, and/or feeding tube dependence in long-term follow-up ⩾1year following radiotherapy. MD Anderson Symptom Inventory - Head and Neck Module (MDASI-HN) scores were analyzed in a nested cross-sectional survey sample of 118 patients. RESULTS: 34 (9.7%, 95% CI: 6.8-13.3%) patients developed ORN and 45 (12.9%, 95% CI: 9.6-16.9%) patients developed chronic dysphagia. Prevalence of chronic dysphagia was significantly higher in ORN cases (12/34, 35%) compared to those who did not develop ORN (33/315, 11%, p<0.001). ORN grade was also significantly associated with prevalence of dysphagia (p<0.001); the majority of patients with grade 4 ORN requiring major surgery (6 patients, 75%) were found to have chronic dysphagia. Summary MDASI-HN symptom scores did not significantly differ by ORN grade. Significantly higher symptom burden was reported, however, among ORN cases compared to those without ORN for MDASI-HN swallowing (p=0.033), problems with teeth and/or gums (p=0.016) and change in activity (p=0.015) item scores. CONCLUSIONS: ORN is associated with excess burden of chronic dysphagia and higher symptom severity related to swallowing, dentition and activity limitations.
Authors: David I Rosenthal; Tito R Mendoza; Mark S Chambers; Joshua A Asper; Ibrahima Gning; Merrill S Kies; Randal S Weber; Jan S Lewin; Adam S Garden; K Kian Ang; Xin S Wang; Charles S Cleeland Journal: Head Neck Date: 2007-10 Impact factor: 3.147
Authors: Shamir P Chandarana; Eric J P Chanowski; Keith A Casper; Gregory T Wolf; Carol R Bradford; Francis P Worden; Avraham Eisbruch; Douglas B Chepeha Journal: J Reconstr Microsurg Date: 2012-10-23 Impact factor: 2.873
Authors: Ik Jae Lee; Woong Sub Koom; Chang Geol Lee; Yong Bae Kim; Sei Whan Yoo; Ki Chang Keum; Gwi Eon Kim; Eun Chang Choi; In Ho Cha Journal: Int J Radiat Oncol Biol Phys Date: 2009-03-26 Impact factor: 7.038
Authors: Jimmy J Caudell; Philip E Schaner; Ruby F Meredith; Julie L Locher; Lisle M Nabell; William R Carroll; J Scott Magnuson; Sharon A Spencer; James A Bonner Journal: Int J Radiat Oncol Biol Phys Date: 2008-07-16 Impact factor: 7.038
Authors: Puja Aggarwal; Jhankruti S Zaveri; Ryan P Goepfert; Qiuling Shi; Xianglin L Du; Michael Swartz; G Brandon Gunn; Stephen Y Lai; C David Fuller; Ehab Y Hanna; David I Rosenthal; Jan S Lewin; Linda B Piller; Katherine A Hutcheson Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-11-01 Impact factor: 6.223
Authors: Mohammad K Hararah; William A Stokes; Bernard L Jones; Ayman Oweida; Ding Ding; Jessica McDermott; Julie Goddard; Sana D Karam Journal: Oral Oncol Date: 2018-06-13 Impact factor: 5.337
Authors: Souptik Barua; Hesham Elhalawani; Stefania Volpe; Karine A Al Feghali; Pei Yang; Sweet Ping Ng; Baher Elgohari; Robin C Granberry; Dennis S Mackin; G Brandon Gunn; Katherine A Hutcheson; Mark S Chambers; Laurence E Court; Abdallah S R Mohamed; Clifton D Fuller; Stephen Y Lai; Arvind Rao Journal: Front Artif Intell Date: 2021-04-09
Authors: M Sean Peach; Daniel M Trifiletti; Carolyn Vachani; Karen Arnold-Korzeniowski; Christina Bach; Margaret Hampshire; James M Metz; Christine E Hill-Kayser Journal: Patient Relat Outcome Meas Date: 2018-07-27