Correlation between dose to the pharyngeal constrictors and patient quality of life and late dysphagia following chemo-IMRT for head and neck cancer.
OBJECTIVE
Aim of this study was to correlate dose to pharyngeal constrictors (PC) with subjective and observer-based assessments of swallowing in patients with head and neck cancer undergoing concomitant chemo-IMRT.


METHODS
Dose-volume histograms (DVHs) for superior constrictor (SC), middle constrictor (MC) and inferior constrictor (IC) were generated for 37 patients. Mean doses to SC, MC and IC were correlated to objective dysphagia grade (1 year, RTOG scoring) and global, total physical (TP) and most relevant components of the physical section (P6, P8) of the MD Anderson dysphagia inventory (MDADI) which was evaluated post-treatment. Odds ratios of dysphagia (>grade 0), poor global (<3), TP (<32), P6 (<3) and P8 (<3) for patients with mean dose>60 Gy to SC and IC were calculated.


RESULTS
There was no significant correlation between mean dose to PC and any of the analysed MDADI parameters and observer-assessed dysphagia grade. Odds ratio of dysphagia (>grade 0), poor global (<3), TP (<32), P6 (<3) and P8 (<3) for patients with mean dose>60 Gy to IC and SC were not significantly higher than those for patients receiving <60 Gy.


CONCLUSIONS
This study did not find a statistically significant correlation between radiation dose to the PC and observer-assessed dysphagia grade or patient-reported MDADI questionnaire at 1 year.
Bhide
Shreerang A
SA
The Institute of Cancer Research, London, UK.
Gulliford
Sarah
S
Kazi
Rehan
R
El-Hariry
Iman
I
Newbold
Kate
K
Harrington
Kevin J
KJ
Nutting
Christopher M
CM
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology* / Q000473:pathology; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D010609:Pharyngeal Muscles / Q000000981:diagnostic imaging / Q000528:radiation effects*; D011788:Quality of Life; D011829:Radiation Dosage; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D014057:Tomography, X-Ray Computed