Results of fiberoptic endoscopic evaluation of swallowing vs. radiation dose in the swallowing muscles after radiotherapy of cancer in the oropharynx.
OBJECTIVE
Dysphagia is a serious complaint but frequently underreported. This paper assesses for oropharyngeal cancer (OPC) the relationship between the dose received by the swallowing structures, and the findings of a fiberoptic endoscopic evaluation of the swallowing process (FEES).


METHODS
Between 2000 and 2005, 60 of 67 OPC patients local-regionally NED for at least one year following treatment responded to three types of QoL questionnaires; i.e. Performance Status Scales, EORTC H&N35, and M.D. Anderson Dysphagia Inventory. Twenty-four patients agreed to the FEES procedure. The main swallowing muscles were delineated, with the mean dose per muscle calculated using the original 3D CT-based treatment plans. Regression analysis was performed between FEES variables and the doses in the different swallowing muscles and the dysphagia related questionnaires.


RESULTS
A significant relationship was found between the results of FEES and the mean dose in the superior constrictor muscle (SCM). Some of the subjective dysphagia complaints were significantly correlated with the FEES variables in this retrospectively study.


CONCLUSIONS
A higher dose in the SCM generally results in worsening of the findings obtained by the FEES examination.
Teguh
David N
DN
Department of Radiation Oncology, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Levendag
Peter C
PC
Sewnaik
Aniel
A
Hakkesteegt
Marieke M
MM
Noever
Inge
I
Voet
Peter
P
van der Est
Henrie
H
Sipkema
Dick
D
van Rooij
Peter
P
Baatenburg de Jong
Robert Jan
RJ
Schmitz
Paul I M
PI
D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology*; D004307:Dose-Response Relationship, Radiation; D004724:Endoscopy; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011788:Quality of Life; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012044:Regression Analysis; D011795:Surveys and Questionnaires