Influence of radiation dose to pharyngeal constrictor muscles on late dysphagia and quality of life in patients with locally advanced oropharyngeal carcinoma.
Strahlenther Onkol
; 196(6): 522-529, 2020 Jun.
Article
em En
| MEDLINE
| ID: mdl-32006068
ABSTRACT
BACKGROUND AND OBJECTIVE:
Patients with oropharyngeal carcinoma (OPC) often have difficulty swallowing, which may affect quality of life (QoL). Radiation dose to constrictor muscles plays an important role.METHODS:
54 patients with locally advanced OPC were evaluated after intensity-modulated radiotherapy. Data were collected at standardized intervals using the EORTC questionnaires QLQ-C30 and QLQ-HN35 within two years. The pharyngeal constrictors (superior, middle, and inferior) were each contoured as an organ at risk. Influence of dose to the constrictors (≥55 Gy vs. <55 Gy) on late dysphagia and QoL was analyzed using the ttest.RESULTS:
Late radiation-induced dysphagia depends significantly on the dose to the lower pharyngeal constrictor. At a dose of ≥55â¯Gy, 14 (64%) patients developed dysphagia grade ≤2 and 8 (36%) patients grade ≥3. At a dose of <55â¯Gy, the distribution at the end of radiotherapy (RT) was similar 22 (69%) patients with dysphagia grade ≤2, 10 (31%) with grade ≥3. There was no dose-dependent difference in the severity of dysphagia in the acute phase (pâ¯= 0.989). There were differences 18 months after the end of RT ≥55â¯Gy 19 (86%) patients showed dysphagia grade ≤2; 3 (14%) grade ≥3. At <55â¯Gy, 31 (97%) patients developed grade ≤2, 1 (3%) grade ≥3 (18 months p = 0.001; 24 months pâ¯= 0.000). Late dysphagia is also dependent on the dose level of the middle constrictor muscle (6 months pâ¯= 0.000; 12 months pâ¯= 0.005, 18 months pâ¯= 0.034). After 24 months, there was no significant difference (pâ¯= 0.374).CONCLUSION:
Radiation dose to the upper constrictor muscle appears to be of little relevance. The middle and lower constrictor should be given special consideration to avoid late dysphagia. Long-term QoL is independent on radiation dose.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Músculos Faríngeos
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Lesões por Radiação
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Carcinoma
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Transtornos de Deglutição
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Neoplasias Orofaríngeas
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Radioterapia de Intensidade Modulada
Tipo de estudo:
Etiology_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article