Stefano Ursino1,2, Paola Cocuzza3, Veronica Seccia4, Durim Delishaj3, Agostino Cristaudo3, Francesco Pasqualetti3, Patrizia Giusti5, Stefania Santopadre6, Riccardo Morganti7, Francesco Fiorica8, Fabiola Paiar3, Bruno Fattori6. 1. Department of Radiation Oncology, University Hospital S. Chiara, Via Roma 55, Pisa, Italy. stefano.ursino@med.unipi.it. 2. Department of Radiation Oncology, University Hospital Santa Chiara, Via Roma 67, 56126, Pisa, Italy. stefano.ursino@med.unipi.it. 3. Department of Radiation Oncology, University Hospital S. Chiara, Via Roma 55, Pisa, Italy. 4. First Otorhinolaryngology Unit, University Hospital Cisanello, Via Paradisa 2, Pisa, Italy. 5. Department of Radiology, University Hospital Cisanello, Via Paradisa 2, Pisa, Italy. 6. Otorhinolaryngology-Audiology-Phoniatric Unit, University Hospital Cisanello, Via Paradisa 2, Pisa, Italy. 7. Department of Clinical and Experimental Medicine, Section of Statistics, Via Roma 55, Pisa, Italy. 8. Department of Radiation Oncology, University Hospital Ferrara, Via Aldo Moro 8, Cona, Ferrara, Italy.
Abstract
BACKGROUND AND PURPOSE: A prospective instrumental assessment of late dysphagia using swallowing organs at risk (SWOARs)-sparing IMRT for nasopharyngeal and oropharyngeal cancers. MATERIALS AND METHODS: Objective instrumental assessment included fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy (VFS) at baseline, and at 6 and 12 months after treatment. FEES assessed the pharyngeal residue according to the Farneti pooling score (P-score) as follows: 4-5 no dysphagia; 6-7 mild dysphagia; 8-9 moderate dysphagia; 10-11 severe dysphagia. Three different consistencies were tested for the P‑score: liquid (L), semisolid (SS), and solid (S). VFS assessed penetration-aspiration according to the Penetration-Aspiration Scale (PAS) and two different consistencies of the bolus were tested: thin liquid barium (L) and paste barium (S). RESULTS: 38 patients were evaluable. There was a significant worsening of the P‑score at 6 months both for SS (p = 0.015) and S (p < 0.001), which persisted only for S at 12 months (p < 0.0001). Similarly, there was a significant worsening of the PAS score at 6 and 12 months (p = 0.065 and 0.039, respectively) for the S bolus. Overall, 3-7 and 10-14% aspiration after L and S was observed, respectively. CONCLUSIONS: Promising results using a SWOARs-sparing IMRT technique are reported. Therefore, treatment plans should be optimized for reducing doses to these structures.
BACKGROUND AND PURPOSE: A prospective instrumental assessment of late dysphagia using swallowing organs at risk (SWOARs)-sparing IMRT for nasopharyngeal and oropharyngeal cancers. MATERIALS AND METHODS: Objective instrumental assessment included fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy (VFS) at baseline, and at 6 and 12 months after treatment. FEES assessed the pharyngeal residue according to the Farneti pooling score (P-score) as follows: 4-5 no dysphagia; 6-7 mild dysphagia; 8-9 moderate dysphagia; 10-11 severe dysphagia. Three different consistencies were tested for the P‑score: liquid (L), semisolid (SS), and solid (S). VFS assessed penetration-aspiration according to the Penetration-Aspiration Scale (PAS) and two different consistencies of the bolus were tested: thin liquid barium (L) and paste barium (S). RESULTS: 38 patients were evaluable. There was a significant worsening of the P‑score at 6 months both for SS (p = 0.015) and S (p < 0.001), which persisted only for S at 12 months (p < 0.0001). Similarly, there was a significant worsening of the PAS score at 6 and 12 months (p = 0.065 and 0.039, respectively) for the S bolus. Overall, 3-7 and 10-14% aspiration after L and S was observed, respectively. CONCLUSIONS: Promising results using a SWOARs-sparing IMRT technique are reported. Therefore, treatment plans should be optimized for reducing doses to these structures.
Entities:
Keywords:
Aspiration-pneumonia; Dysphagia; Fiberoptic endoscopic evaluation of swallowing; Radiotherapy; Videofluoroscopy
Authors: Margaret Patterson; Rowena Brain; Ronald Chin; David Veivers; Michael Back; Andrew Wignall; Thomas Eade Journal: Dysphagia Date: 2014-08-13 Impact factor: 3.438
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Authors: Arlene A Forastiere; Qiang Zhang; Randal S Weber; Moshe H Maor; Helmuth Goepfert; Thomas F Pajak; William Morrison; Bonnie Glisson; Andy Trotti; John A Ridge; Wade Thorstad; Henry Wagner; John F Ensley; Jay S Cooper Journal: J Clin Oncol Date: 2012-11-26 Impact factor: 44.544
Authors: S Ursino; V Seccia; P Cocuzza; P Ferrazza; T Briganti; F Matteucci; L Fatigante; P Giusti; M Grosso; L Locantore; R Morganti; A Nacci; S Sellari Franceschini; F Paiar; D Caramella; B Fattori Journal: Acta Otorhinolaryngol Ital Date: 2016-03-31 Impact factor: 2.124