title: Radiation dose to the tongue and velopharynx predicts acoustic-articulatory changes after chemo-IMRT treatment for advanced head and neck cancer.
abstract: The aim of this study was to investigate to what extent changes in speech after C-IMRT treatment are related to mean doses to the tongue and velopharynx (VP). In 34 patients with advanced hypopharyngeal, nasopharyngeal, or oropharyngeal cancer, changes in speech from pretreatment to 10 weeks and 1 year posttreatment were correlated with mean doses to the base of tongue (BOT), oral cavity (OC) and tonsillar fossa/soft palate (VP). Differences in anteroposterior tongue position, dorsoventral degree of tongue to palate or pharynx constriction, grooving, strength, nasality, and laryngeal rise, were assessed by acoustic changes in three speech sounds that depend on a (post-) alveolar closure or narrowing (/t/, /s/, /z/), three with a tongue to palate/pharyngeal narrowing (/l/, /r/, /u/), and in vowel /a/ at comfortable and highest pitch. Acoustically assessed changes in tongue positioning, shape, velopharyngeal constriction, and laryngeal elevation were significantly related to mean doses to the tongue and velopharynx. The mean dose to BOT predicted changes in anteroposterior tongue positioning from pre- to 10-weeks posttreatment. From pretreatment to 1-year, mean doses to BOT, OC, and VP were related to changes in grooving, strength, laryngeal height, nasality, palatalization, and degree of pharyngeal constriction. Changes in speech are related to mean doses to the base of tongue and velopharynx. The outcome indicates that strength, motility, and the balance between agonist and antagonist muscle forces change significantly after radiotherapy.
authors: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. i.jacobi@nki.nl.
authors: Irene
authors: I
authors: Jacobi
authors: Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
authors: Arash
authors: A
authors: Navran
authors: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
authors: Lisette
authors: L
authors: van der Molen
authors: Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.|Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
authors: Wilma D
authors: WD
authors: Heemsbergen
authors: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.|Institute of Phonetic Sciences, ACLC, University of Amsterdam, Spuistraat 210, 1012 VT, Amsterdam, The Netherlands.
authors: Frans J M
authors: FJ
authors: Hilgers
authors: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.|Department of Oral and Maxillofacial Surgery, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.|Institute of Phonetic Sciences, ACLC, University of Amsterdam, Spuistraat 210, 1012 VT, Amsterdam, The Netherlands.
authors: Michiel W M
authors: MW
authors: van den Brekel
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D059248:Chemoradiotherapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007830:Larynx / Q000503:physiopathology / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010609:Pharyngeal Muscles / Q000503:physiopathology / Q000528:radiation effects; D010614:Pharynx / Q000503:physiopathology / Q000528:radiation effects*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D013060:Speech / Q000502:physiology* / Q000528:radiation effects; D000077195:Squamous Cell Carcinoma of Head and Neck; D014059:Tongue / Q000503:physiopathology / Q000528:radiation effects*
keywords: Acoustics; Articulation; Chemoradiation; Head and neck cancer; IMRT; Speech muscles
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