title: Validation of the total dysphagia risk score (TDRS) in head and neck cancer patients in a conventional and a partially accelerated radiotherapy scheme.
abstract: OBJECTIVE
  A risk model, the total dysphagia risk score (TDRS), was developed to predict which patients are most at risk to develop grade ⩾2 dysphagia at 6 months following radiotherapy (RT) for head and neck cancer. The purpose of this study was to validate this model at 6 months and to investigate the power at earlier and later time-points. A second aim was to see if this model can be used in a partially accelerated RT regimen.
  
  
  METHODS
  164 patients from 3 different centres treated with RT between 2008 and 2014 were included in the current study. Both physician-scored dysphagia and QoL data were prospectively obtained. The TDRS of all patients was correlated with the physician-scored dysphagia and the QoL data. To validate this prediction model, we tested the validity in terms of calibration and discrimination.
  
  
  RESULTS
  Partial acceleration had no influence on the TDRS. Regarding physician-scored dysphagia, there was a significant correlation with dysphagia grade ⩾2 at 1, 3, 6 and 9 months. The area-under-the-curve at 1 month was 0.85; at 3 months 0.80; at 6 months 0.85; at 9 months 0.86 and 0.79 at 12 months. Regarding QoL, TDRS correlates with PEG-tube usage at 6 and 12 months.
  
  
  CONCLUSIONS
  We found significant correlations between TDRS and dysphagia grade ⩾2 and PEG-tube usage.
authors.affiliation: KU Leuven - University of Leuven, University Hospitals Leuven, Department of Radiation Oncology, Belgium.
authors.forename: Daan
authors.initials: D
authors.lastname: Nevens
authors.affiliation: KU Leuven - University of Leuven, University Hospitals Leuven, Department of Radiation Oncology, Belgium.
authors.forename: Sarah
authors.initials: S
authors.lastname: Deschuymer
authors.affiliation: Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
authors.affiliation: Department of Radiation Oncology, Clinique et Maternité Sainte-Elisabeth, Namur, Belgium.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Daisne
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, Belgium.
authors.forename: Fréderic
authors.initials: F
authors.lastname: Duprez
authors.affiliation: Department of Radiotherapy, Ghent University Hospital, Belgium.
authors.forename: Wilfried
authors.initials: W
authors.lastname: De Neve
authors.affiliation: KU Leuven - University of Leuven, University Hospitals Leuven, Department of Radiation Oncology, Belgium. Electronic address: Sandra.nuyts@uzleuven.be.
authors.forename: Sandra
authors.initials: S
authors.lastname: Nuyts
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011832:Radiation Injuries / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D012306:Risk
keywords: Dysphagia; Head and neck cancer; Quality of life; Radiotherapy; Total dysphagia risk score