title: Feasibility of Tomotherapy-based image-guided radiotherapy to reduce aspiration risk in patients with non-laryngeal and non-pharyngeal head and neck cancer.
abstract: OBJECTIVE
  The study aims to assess the feasibility of Tomotherapy-based image-guided radiotherapy (IGRT) to reduce the aspiration risk in patients with non-laryngeal and non-hypopharyngeal cancer. A retrospective review of 48 patients undergoing radiation for non-laryngeal and non-hypopharyngeal head and neck cancers was conducted. All patients had a modified barium swallow (MBS) prior to treatment, which was repeated one month following radiotherapy. Mean middle and inferior pharyngeal dose was recorded and correlated with the MBS results to determine aspiration risk.
  
  
  RESULTS
  Mean pharyngeal dose was 23.2 Gy for the whole group. Two patients (4.2%) developed trace aspiration following radiotherapy which resolved with swallowing therapy. At a median follow-up of 19 months (1-48 months), all patients were able to resume normal oral feeding without aspiration.
  
  
  CONCLUSIONS
  IGRT may reduce the aspiration risk by decreasing the mean pharyngeal dose in the presence of large cervical lymph nodes. Further prospective studies with IGRT should be performed in patients with non-laryngeal and non-hypopharyngeal head and neck cancers to verify this hypothesis.
authors.affiliation: Department of Radiation Oncology, University of Arizona, Tucson, Arizona, United States of America. NamPhong.Nguyen@yahoo.com
authors.forename: Nam P
authors.initials: NP
authors.lastname: Nguyen
authors.forename: Lexie
authors.initials: L
authors.lastname: Smith-Raymond
authors.forename: Vincent
authors.initials: V
authors.lastname: Vinh-Hung
authors.forename: Paul
authors.initials: P
authors.lastname: Vos
authors.forename: Rick
authors.initials: R
authors.lastname: Davis
authors.forename: Anand
authors.initials: A
authors.lastname: Desai
authors.forename: Thomas
authors.initials: T
authors.lastname: Sroka
authors.forename: Dave
authors.initials: D
authors.lastname: Abraham
authors.forename: Shane P
authors.initials: SP
authors.lastname: Krafft
authors.forename: Michelle
authors.initials: M
authors.lastname: Stevie
authors.forename: Homayoun
authors.initials: H
authors.lastname: Modarresifar
authors.forename: Beng-Hoey
authors.initials: BH
authors.lastname: Jo
authors.forename: Misty
authors.initials: M
authors.lastname: Ceizyk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D001466:Barium Sulfate