Swallowing dysfunction is a common sequelae after chemoradiation for oropharynx carcinoma.
BACKGROUND
A retrospective review of all patients with advanced oropharynx cancer from a single institution was performed.


METHODS
Sixty-seven patients with stage III/IV oropharynx cancer were treated with definitive radiotherapy with or without concurrent chemotherapy from 1990 to 2004. Follow-up ranged from 6 to 91 months with a median of 32 months.


RESULTS
Patients treated with concurrent chemotherapy had a statistically significant benefit for control above the clavicles, primary control, disease-free survival, and overall survival but no difference in distant control at 3 years. Cox proportional regression model demonstrated the use of concurrent chemotherapy to be the only independent variable that reached significance for control above the clavicles, primary control, and overall survival. Complete dysphagia for solids and/or gastrostomy tube dependence was observed in more patients who were treated with chemoradiation than those treated with radiation alone; 18% and 0%, respectively (P = 0.04).


CONCLUSIONS
Concurrent chemotherapy decreases the recurrence at the primary site and above the clavicles. The most notable difference in sequelae between the 2 groups was the increase in swallowing dysfunction with concurrent chemotherapy.
Departments of Radiation Oncology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. kgreven@wfubmc.edu
Kathryn M
KM
Greven
Douglas R
DR
White
J Dale
JD
Browne
Daniel W
DW
Williams
W Fred
WF
McGuirt
Ralph B
RB
D'Agostino
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000009:adverse effects; D003680:Deglutition Disorders / Q000209:etiology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D017239:Paclitaxel / Q000008:administration & dosage; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012307:Risk Factors
D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin