Prospective swallowing outcomes after IMRT for oropharyngeal cancer: Dosimetric correlations in a population-based cohort.
To identify dose constraints to preserve swallowing after head and neck (H&N) radiotherapy using prospectively collected functional outcomes.



Stage III-IV oropharyngeal cancer patients were prospectively evaluated using the Royal Brisbane Hospital Outcome Measure for Swallowing and Performance Status Scale for H&N Cancer Patients at pre-treatment and 3, 6, 12, and 24months after intensity-modulated radiotherapy. Dosimetric parameters were correlated with swallowing function.



Ninety-six patients were evaluated with median follow-up of 14.1months (interquartile range 9.9-26.3). Six patients (8.3%) remained feeding tube (FT) dependent at 12months. At 2years, 32.6% tolerated a normal diet without restrictions. Mean doses of 55Gy to supraglottic larynx, 44Gy to glottic larynx, 48Gy to cricopharyngeus, and 44Gy to esophageal inlet were associated with >25% risk of FT dependence at 6months.



Higher mean doses to the larynx and pharyngo-esophageal junction were associated with longer duration of FT dependence and dietary restrictions.
Section of Radiation Oncology, Department of Radiology, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Gordon Z
GZ
Guo
CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Keith R
KR
Sutherland
CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Candace
C
Myers
CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Pascal
P
Lambert
Section of Radiation Oncology, Department of Radiology, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Shaun K
SK
Loewen
Section of Radiation Oncology, Department of Radiology, University of Manitoba, Winnipeg, Manitoba, Canada; CancerCare Manitoba, Winnipeg, Manitoba, Canada. Electronic address: harvey.quon@albertahealthservices.ca.
Harvey C
HC
Quon
D000368:Aged; D003679:Deglutition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy*; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*
Deglutition; Enteral nutrition; Head and neck neoplasms; Radiotherapy; Toxicity