Impact of selective neck dissection on chronic dysphagia after chemo-intensity-modulated radiotherapy for oropharyngeal carcinoma.
Conflicting results are reported regarding the impact of neck dissection on radiation-associated dysphagia. The purpose of this study was to reexamine this question specific to oropharyngeal intensity-modulated radiotherapy (IMRT).



Three hundred forty-nine patients with oropharyngeal cancer treated with bilateral IMRT with systemic therapy (induction and/or concurrent) were reviewed. Chronic dysphagia was defined by aspiration, stricture, pneumonia, and/or gastrostomy dependence ≥12 months post-IMRT.



Selective neck dissection was performed after IMRT in 75 patients (21%). Overall, 41 patients (12%) developed chronic dysphagia. Neck dissection did not increase the rate of chronic dysphagia (9% neck dissection; 12% no neck dissection; p = .464) or gastrostomy duration (p = .482). On multivariate analysis, age (odds ratio [OR] per 5-year = 1.25; 95% confidence interval [CI] = 1.04-1.51), baseline abnormal diet (OR = 2.78; 95% CI = 1.31-5.88), and IMRT dose (OR per 5-Gy = 5.11; 95% CI = 1.77-14.81) significantly predicted dysphagia.



In the setting of selective neck dissection for residual adenopathy after IMRT, neck dissection did not impact dysphagia. © 2015 Wiley Periodicals, Inc. Head Neck 38: 886-893, 2016.
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Katherine A
KA
Hutcheson
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Amal R
AR
Abualsamh
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Alejandro
A
Sosa
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Randal S
RS
Weber
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Beth M
BM
Beadle
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Erich M
EM
Sturgis
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jan S
JS
Lewin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000009:adverse effects; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection / Q000009:adverse effects*; D009959:Oropharyngeal Neoplasms / Q000150:complications / Q000628:therapy*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012189:Retrospective Studies
chemoradiation; dysphagia; neck dissection; oropharyngeal cancer