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Influence of radiation dose to pharyngeal constrictor muscles on late dysphagia and quality of life in patients with locally advanced oropharyngeal carcinoma.
Mogadas, S; Busch, C-J; Pflug, C; Hanken, H; Krüll, A; Petersen, C; Tribius, S.
Afiliação
  • Mogadas S; Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Busch CJ; Department of Otolaryngology, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Pflug C; Department of Voice, Speech and Hearing Disorders, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Hanken H; Department of Oral & Maxillofacial Surgery, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Krüll A; Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Petersen C; Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Tribius S; Department of Radiation Oncology, Asklepios Hospital St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany. s.tribius@asklepios.com.
Strahlenther Onkol ; 196(6): 522-529, 2020 Jun.
Article em En | MEDLINE | ID: mdl-32006068
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 ≥55 Gy, 14 (64%) patients developed dysphagia grade ≤2 and 8 (36%) patients grade ≥3. At a dose of <55 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 (p = 0.989). There were differences 18 months after the end of RT: ≥55 Gy: 19 (86%) patients showed dysphagia grade ≤2; 3 (14%) grade ≥3. At <55 Gy, 31 (97%) patients developed grade ≤2, 1 (3%) grade ≥3 (18 months: p = 0.001; 24 months: p = 0.000). Late dysphagia is also dependent on the dose level of the middle constrictor muscle (6 months: p = 0.000; 12 months: p = 0.005, 18 months: p = 0.034). After 24 months, there was no significant difference (p = 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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Músculos Faríngeos / Lesões por Radiação / Carcinoma / Transtornos de Deglutição / Neoplasias Orofaríngeas / Radioterapia de Intensidade Modulada Tipo de estudo: Etiology_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Músculos Faríngeos / Lesões por Radiação / Carcinoma / Transtornos de Deglutição / Neoplasias Orofaríngeas / Radioterapia de Intensidade Modulada Tipo de estudo: Etiology_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article