Stefano Ursino1, Elisa D'Angelo2, Rosario Mazzola3, Anna Merlotti4, Riccardo Morganti5, Agostino Cristaudo5, Fabiola Paiar5, Daniela Musio6, Daniela Alterio7, Almalina Bacigalupo8, Elvio Grazioso Russi4, Frank Lohr2. 1. Radiation Oncology, University Hospital S. Chiara, Via Roma 55, 56126, Pisa, Italy. stefano.ursino@med.unipi.it. 2. Radiation Oncology, University Hospital, Largo del Pozzo 74, 44125, Modena, Italy. 3. Radiation Oncology, Sacro Cuore-Don Calabria Cancer Care Center, Via Don Sempreboni 5, 37024, Negrar-Verona, Italy. 4. Radiation Oncology, S.Croce e Carle Hospital, Via M. Coppino 26, 12100, Cuneo, Italy. 5. Radiation Oncology, University Hospital S. Chiara, Via Roma 55, 56126, Pisa, Italy. 6. Radiation Oncology, University Hospital La Sapienza, Viale del Policlinico 155, 00161, Roma, Italy. 7. Radiation Oncology, Advanced Radiotherapy Center, European Institute of Oncology, Via G. Ripamonti 435, 20141, Milan, Italy. 8. Radiation Oncology, AOU IRCCS San Martino - IST National Cancer Research Institute and University, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
Abstract
PURPOSE: Dysphagia is one of the most important treatment-related side effects in head and neck cancer (HNC), as it can lead to severe life-threating complications such as aspiration pneumonia and malnutrition. Intensity-modulated radiotherapy (IMRT) could reduce swallowing dysfunction by producing a concave dose distribution and reducing doses to the swallowing-related organs at risk (SWOARs). The aim of this study was to review the current literature in order to compare swallowing outcomes between IMRT and three-dimensional conformal radiotherapy (3DCRT). METHODS: A search was conducted in the PubMed and Embase databases to identify studies on swallowing outcomes, both clinically and/or instrumentally assessed, after 3DCRT and IMRT. Dysphagia-specific quality of life and objective instrumental data are summarized and discussed. RESULTS: A total of 262 papers were retrieved from the searched databases. An additional 23 papers were retrieved by hand-searching the reference lists. Ultimately, 22 papers were identified which discussed swallowing outcomes after 3DCRT and IMRT for HNC. No outcomes from randomized trials were identified. CONCLUSION: Despite several methodological limitations, reports from the current literature seem to suggest better swallowing outcomes with IMRT compared to 3DCRT. Further improvements are likely to result from the increased use of IMRT plans optimized for SWOAR sparing.
PURPOSE:Dysphagia is one of the most important treatment-related side effects in head and neck cancer (HNC), as it can lead to severe life-threating complications such as aspiration pneumonia and malnutrition. Intensity-modulated radiotherapy (IMRT) could reduce swallowing dysfunction by producing a concave dose distribution and reducing doses to the swallowing-related organs at risk (SWOARs). The aim of this study was to review the current literature in order to compare swallowing outcomes between IMRT and three-dimensional conformal radiotherapy (3DCRT). METHODS: A search was conducted in the PubMed and Embase databases to identify studies on swallowing outcomes, both clinically and/or instrumentally assessed, after 3DCRT and IMRT. Dysphagia-specific quality of life and objective instrumental data are summarized and discussed. RESULTS: A total of 262 papers were retrieved from the searched databases. An additional 23 papers were retrieved by hand-searching the reference lists. Ultimately, 22 papers were identified which discussed swallowing outcomes after 3DCRT and IMRT for HNC. No outcomes from randomized trials were identified. CONCLUSION: Despite several methodological limitations, reports from the current literature seem to suggest better swallowing outcomes with IMRT compared to 3DCRT. Further improvements are likely to result from the increased use of IMRT plans optimized for SWOAR sparing.
Entities:
Keywords:
Chemotherapy; Dysphagia; Organs at risk; Pneumonia, aspiration; Quality of life
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