Late esophageal toxicity after radiation therapy for head and neck cancer.
BACKGROUND
The aim of this study was to determine the incidence of esophageal toxicity after radiation therapy for head and neck cancer.


METHODS
The records of 211 patients treated by radiation therapy for head and neck cancer were reviewed to identify those with dysphagia lasting more than 90 days after therapy. Late toxicity criteria established by the Radiation Therapy Oncology Group were used to score the symptoms.


RESULTS
The incidence of grade 3+ esophageal toxicity at 3 and 6 months was 30% and 19%, respectively. The rate of gastrotomy-tube dependence at 3 and 6 months was 20% and 11%, respectively. Hypopharyngeal and unknown primary site (p = .01, for both), T4 disease (p = .01), and the use of concurrent chemotherapy (p = .001) were associated with grade 3+ esophageal toxicity and stricture formation.


CONCLUSIONS
A significant proportion of patients exhibit symptoms of esophageal toxicity after radiation therapy for head and neck cancer. Therefore, preventive strategies need further investigation.
Chen
Allen M
AM
Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, California 95817, USA. allen.chen@ucdmc.ucdavis.edu
Li
Bao-Qing
BQ
Jennelle
Richard L S
RL
Lau
Derick H
DH
Yang
Claus C
CC
Courquin
Jean
J
Vijayakumar
Srinivasan
S
Purdy
James A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003680:Deglutition Disorders / Q000145:classification / Q000209:etiology*; D019583:Dose Fractionation, Radiation; D004940:Esophageal Stenosis / Q000209:etiology / Q000473:pathology; D004947:Esophagus / Q000528:radiation effects; D005260:Female; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015431:Weight Loss