Dysphagia after definitive radiotherapy for head and neck cancer. Correlation of dose-volume parameters of the pharyngeal constrictor muscles

Strahlenther Onkol. 2013 Mar;189(3):230-6. doi: 10.1007/s00066-012-0288-8. Epub 2013 Jan 16.

Abstract

Background: Dysphagia is a complication of head and neck cancer patients undergoing radiotherapy (RT). We analysed frequency and severity of swallowing dysfunction and correlated these findings with dose-volume histograms (DVHs) of the pharyngeal constrictor muscles.

Methods: A total of 50 patients treated by radical RT were enrolled. DVHs of constrictor muscles were correlated with acute and late dysphagia and with the items of three quality of life questionnaires.

Results: Mean dose to superior and middle constrictor muscles (SCM, MCM), partial volume of SCM and MCM receiving a dose ≥ 50 Gy dose to the whole constrictor muscles ≥ 60 Gy and tumour location were associated to late dysphagia at univariate analysis. Mean dose to the MCM was the only statistically significant predictor of late dysphagia at the multivariable analysis.

Conclusion: The study shows a significant relationship between long-term dysphagia and mean doses to SCM, MCM, whole constrictor muscles, and oropharyngeal tumour. This finding suggests a potential advantage in reducing the RT dose to swallowing structures to avoid severe dysphagia.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Cross-Sectional Studies
  • Deglutition Disorders / epidemiology
  • Deglutition Disorders / etiology*
  • Female
  • Humans
  • Lymphatic Irradiation / methods
  • Lymphatic Metastasis / radiotherapy
  • Male
  • Middle Aged
  • Neoplasm Micrometastasis / radiotherapy
  • Neoplasm Staging
  • Otorhinolaryngologic Neoplasms / pathology
  • Otorhinolaryngologic Neoplasms / radiotherapy*
  • Pharyngeal Muscles / radiation effects*
  • Quality of Life
  • Radiation Injuries / epidemiology
  • Radiation Injuries / etiology*
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Conformal
  • Radiotherapy, Intensity-Modulated
  • Retrospective Studies
  • Statistics as Topic
  • Surveys and Questionnaires