Dose to Larynx Predicts for Swallowing Complications After Intensity-Modulated Radiotherapy

Caglar, Hale B; Tishler, Roy B; Othus, Megan; Burke, Elaine; Yi, Li; Goguen, Laura; Wirth, Lori J; Haddad, Robert I; Norris, Carl M; Court, Laurence E; Aninno, Donald J. D.; Posner, Marshall R

doi:10.1016/j.ijrobp.2008.02.048

Title: Dose to Larynx Predicts for Swallowing Complications After Intensity-Modulated Radiotherapy

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Abstract

Purpose: To evaluate early swallowing after intensity-modulated radiotherapy for head and neck squamous cell carcinoma and determine factors correlating with aspiration and/or stricture. Methods and Materials: Consecutive patients treated with intensity-modulated radiotherapy with or without chemotherapy between September 2004 and August 2006 at the Dana Farber Cancer Institute/Brigham and Women's Hospital were evaluated with institutional review board approval. Patients underwent swallowing evaluation after completion of therapy; including video swallow studies. The clinical- and treatment-related variables were examined for correlation with aspiration or strictures, as well as doses to the larynx, pharyngeal constrictor muscles, and cervical esophagus. The correlation was assessed with logistic regression analysis. Results: A total of 96 patients were evaluated. Their median age was 55 years, and 79 (82%) were men. The primary site of cancer was the oropharynx in 43, hypopharynx/larynx in 17, oral cavity in 13, nasopharynx in 11, maxillary sinus in 2, and unknown primary in 10. Of the 96 patients, 85% underwent definitive RT and 15% postoperative RT. Also, 28 patients underwent induction chemotherapy followed by concurrent chemotherapy, 59 received concurrent chemotherapy, and 9 patients underwent RT alone. The median follow-up was 10 months. Of the 96 patients, 31 (32%) had clinically significant aspirationmore »« less

Authors:

Caglar, Hale B; Tishler, Roy B ^[1]; Othus, Megan ^[2]; Burke, Elaine ^[3]; Yi, Li ^[2]; Goguen, Laura ^[4]; Wirth, Lori J; Haddad, Robert I ^[3]; Norris, Carl M ^[4]; Court, Laurence E ^[1]; Aninno, Donald J. D. ^[4]; Posner, Marshall R ^[3]

Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, MA (United States)
Department of Biostatistics, Dana-Farber Cancer Institute, Boston, MA (United States)
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA (United States)
Department of Otolaryngology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, MA (United States)

Publication Date:: Sat Nov 15 00:00:00 EST 2008

OSTI Identifier:: 21172463

Resource Type:: Journal Article

Journal Name:: International Journal of Radiation Oncology, Biology and Physics

Additional Journal Information:: Journal Volume: 72; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2008.02.048; PII: S0360-3016(08)00350-7; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; ESOPHAGUS; HEAD; LARYNX; NECK; ORAL CAVITY; PATIENTS; PHARYNX; RADIATION DOSES; RADIOTHERAPY; REGRESSION ANALYSIS; SIDE EFFECTS

Citation Formats


                    Caglar, Hale B, Tishler, Roy B, Othus, Megan, Burke, Elaine, Yi, Li, Goguen, Laura, Wirth, Lori J, Haddad, Robert I, Norris, Carl M, Court, Laurence E, Aninno, Donald J. D., Posner, Marshall R, and Allen, Aaron M. Dose to Larynx Predicts for Swallowing Complications After Intensity-Modulated Radiotherapy.  United States: N. p., 2008. 
        Web.  doi:10.1016/j.ijrobp.2008.02.048.

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                    Caglar, Hale B, Tishler, Roy B, Othus, Megan, Burke, Elaine, Yi, Li, Goguen, Laura, Wirth, Lori J, Haddad, Robert I, Norris, Carl M, Court, Laurence E, Aninno, Donald J. D., Posner, Marshall R, & Allen, Aaron M. Dose to Larynx Predicts for Swallowing Complications After Intensity-Modulated Radiotherapy.  United States.  https://doi.org/10.1016/j.ijrobp.2008.02.048

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                    Caglar, Hale B, Tishler, Roy B, Othus, Megan, Burke, Elaine, Yi, Li, Goguen, Laura, Wirth, Lori J, Haddad, Robert I, Norris, Carl M, Court, Laurence E, Aninno, Donald J. D., Posner, Marshall R, and Allen, Aaron M. 2008.  
        "Dose to Larynx Predicts for Swallowing Complications After Intensity-Modulated Radiotherapy".  United States.  https://doi.org/10.1016/j.ijrobp.2008.02.048.

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@article{osti_21172463,

  title        = {Dose to Larynx Predicts for Swallowing Complications After Intensity-Modulated Radiotherapy},

  author       = {Caglar, Hale B and Tishler, Roy B and Othus, Megan and Burke, Elaine and Yi, Li and Goguen, Laura and Wirth, Lori J and Haddad, Robert I and Norris, Carl M and Court, Laurence E and Aninno, Donald J. D. and Posner, Marshall R and Allen, Aaron M.},

  abstractNote = {Purpose: To evaluate early swallowing after intensity-modulated radiotherapy for head and neck squamous cell carcinoma and determine factors correlating with aspiration and/or stricture. Methods and Materials: Consecutive patients treated with intensity-modulated radiotherapy with or without chemotherapy between September 2004 and August 2006 at the Dana Farber Cancer Institute/Brigham and Women's Hospital were evaluated with institutional review board approval. Patients underwent swallowing evaluation after completion of therapy; including video swallow studies. The clinical- and treatment-related variables were examined for correlation with aspiration or strictures, as well as doses to the larynx, pharyngeal constrictor muscles, and cervical esophagus. The correlation was assessed with logistic regression analysis. Results: A total of 96 patients were evaluated. Their median age was 55 years, and 79 (82%) were men. The primary site of cancer was the oropharynx in 43, hypopharynx/larynx in 17, oral cavity in 13, nasopharynx in 11, maxillary sinus in 2, and unknown primary in 10. Of the 96 patients, 85% underwent definitive RT and 15% postoperative RT. Also, 28 patients underwent induction chemotherapy followed by concurrent chemotherapy, 59 received concurrent chemotherapy, and 9 patients underwent RT alone. The median follow-up was 10 months. Of the 96 patients, 31 (32%) had clinically significant aspiration and 36 (37%) developed a stricture. The radiation dose-volume metrics, including the volume of the larynx receiving {>=}50 Gy (p = 0.04 and p = 0.03, respectively) and volume of the inferior constrictor receiving {>=}50 Gy (p = 0.05 and p = 0.02, respectively) were significantly associated with both aspiration and stricture. The mean larynx dose correlated with aspiration (p = 0.003). Smoking history was the only clinical factor to correlate with stricture (p = 0.05) but not aspiration. Conclusion: Aspiration and stricture are common side effects after intensity-modulated radiotherapy for head-and-neck squamous cell carcinoma. The dose given to the larynx and inferior constrictors correlated with these side effects.},

  doi          = {10.1016/j.ijrobp.2008.02.048},

  url          = {https://www.osti.gov/biblio/21172463},
  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  issn         = {0360-3016},

  number       = 4,

  volume       = 72,

  place        = {United States},

  year         = {Sat Nov 15 00:00:00 EST 2008},

  month        = {Sat Nov 15 00:00:00 EST 2008}

}

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