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Radiation-induced acute dysphagia
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Journal Article
Radiation-induced acute dysphagia
2017
Overview
Purpose
Acute toxicity in head and neck (H&N) cancer patients treated with definitive radiotherapy (RT) has a crucial role in compliance to treatments. The aim of this study was to correlate doses to swallowing-associated structures and acute dysphagia.
Methods
We prospectively analyzed 42 H&N cancer patients treated with RT. Dysphagia (grade ≥ 3) and indication for percutaneous endoscopic gastrostomy (PEG) insertion were classified as acute toxicity. Ten swallowing-related structures were considered for the dosimetric analysis. The correlation between clinical information and the dose absorbed by the contoured structures was analyzed. Multivariate logistic regression method using resampling methods (bootstrapping) was applied to select model order and parameters for normal tissue complication probability (NTCP) modelling.
Results
A strong multiple correlation between dosimetric parameters was found. A two-variable model was suggested as the optimal order by bootstrap method. The optimal model (Rs = 0.452,
p
< 0.001) includes V
45
of the cervical esophagus (odds ratio [OR] = 1.016) and D
mean
of the cricopharyngeal muscle (OR = 1.057). The model area under the curve was 0.82 (95% confidence interval 0.69–0.95).
Conclusion
Our results suggested that the absorbed dose to the cricopharyngeal muscle and cervical esophagus might play a relevant role in the development of acute RT-related dysphagia.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
/ Aged
/ Cancer
/ Carcinoma, Squamous Cell - radiotherapy
/ Deglutition - radiation effects
/ Deglutition Disorders - etiology
/ Deglutition Disorders - therapy
/ Esophagus - radiation effects
/ Female
/ Humans
/ Male
/ Medicine
/ Oncology
/ Ostomy
/ Otorhinolaryngologic Neoplasms - radiotherapy
/ Patients
/ Pharyngeal Muscles - radiation effects
/ Quality
/ Radiation Injuries - etiology
/ Radiation Injuries - therapy
/ Toxicity
