Dysphagia - Results from multivariable predictive modelling on aspiration from a subset of the ARTSCAN trial.
To establish predictive models for late objective aspiration and late patient-reported choking based on dose-volume parameters and baseline patient and treatment characteristics, for patients with head and neck cancer undergoing definitive radiotherapy (RT). The impact of electively treated volume on late aspiration was also investigated.



This prospective cohort is a subsample of 124 survivors from the ARTSCAN study. Late aspiration was identified with videofluoroscopy, at a minimum of 25months after the start of RT. Patient-reported choking was analysed at 12 and 60months post RT using the EORTC Quality of Life Module for Head and Neck Cancer 35. Univariable and multivariable analyses were performed to describe the association between clinical factors and dose-volume descriptors for organs at risk (OARs) and late dysphagia.



Aspiration was found in 47% of the eligible patients. Mean dose to the middle pharyngeal constrictor (MPC), neck dissection post RT and age at randomisation in ARTSCAN were associated to late aspiration. Mean dose to the superior pharyngeal constrictor (SPC) and swallowing complaints at baseline were associated to patient reported choking at both time-points.



Three separate risk groups for late aspiration, and two risk groups for late patient-reported choking were identified based on number of risk factors. The size of the electively treated volume could be used as a surrogate for individual OARs predicting late aspiration.
Department of Radiation Sciences, Oncology, Umeå University Hospital, Umeå University, Sweden. Electronic address: karin.soderstrom@onkologi.umu.se.
Karin
K
Söderström
Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Sweden. Electronic address: per.nilsson@skane.se.
Per
P
Nilsson
Department of Surgical Sciences, Uppsala University, Sweden. Electronic address: goran.laurell@surgsci.uu.se.
Göran
G
Laurell
Department of Radiation Sciences, Oncology, Umeå University Hospital, Umeå University, Sweden. Electronic address: bjorn.zackrisson@umu.se.
Björn
B
Zackrisson
Department of Odontology, Oral and Maxillofacial Radiology, Umeå University, Sweden. Electronic address: eva.levring.jaghagen@umu.se.
Eva Levring
EL
Jäghagen
D000328:Adult; D000368:Aged; D003679:Deglutition; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000523:psychology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058958:Organs at Risk; D010609:Pharyngeal Muscles / Q000528:radiation effects; D011446:Prospective Studies; D011788:Quality of Life
Dysphagia; Head and neck cancer; Normal tissue complication probability; Radiotherapy