Dose-volumerelated dysphagia after constrictor muscles definition in head and neck cancer intensitymodulated radiation treatment

R. Mazzola, F. Ricchetti, A. Fiorentino, S. Fersino, N. Giaj Levra, S. Naccarato, G. Sicignano, S. Albanese, G. Di Paola, D. Alterio, R. Ruggieri, F. Alongi

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective: Dysphagia remains a side effect influencing the quality of life of patients with head and neck cancer (HNC) after radiotherapy. We evaluated the relationship between planned dose involvement and acute and late dysphagia in patients with HNC treated with intensitymodulated radiation therapy (IMRT), after a recontouring of constrictor muscles (PCs) and the cricopharyngeal muscle (CM). Methods: Between December 2011 and December 2013, 56 patients with histologically proven HNC were treated with IMRT or volumetric-modulated arc therapy. The PCs and CM were recontoured. Correlations between acute and late toxicity and dosimetric parameters were evaluated. End points were analysed using univariate logistic regression. Results: An increasing risk to develop acute dysphagia was observed when constraints to the middle PCs were not respected [mean dose (DMEAN) ≥50Gy, maximum dose (Dmax).60Gy, V50.70% with a p50.05]. The superior PC was not correlated with acute toxicity but only with late dysphagia. The inferior PC was not correlated with dysphagia; for the CM only, Dmax.60Gy was correlated with acute dysphagia grade 2. Conclusion: According to our analysis, the superior PC has a major role, being correlated with dysphagia at 3 and 6 months after treatments; the middle PC maintains this correlation only at 3 months from the beginning of radiotherapy, but it does not have influence on late dysphagia. The inferior PC and CM have a minimum impact on swallowing symptoms. Advances in knowledge: We used recent guidelines to define dose constraints of the PCs and CM. Two results emerge in the present analysis: the superior PC influences late dysphagia, while the middle PC influences acute dysphagia.

Original languageEnglish
JournalBritish Journal of Radiology
Volume87
Issue number1044
DOIs
Publication statusPublished - Dec 1 2014

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Head and Neck Neoplasms
Deglutition Disorders
Radiation
Muscles
Radiotherapy
Therapeutics
Intensity-Modulated Radiotherapy
Deglutition
Logistic Models
Quality of Life
Guidelines

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Dose-volumerelated dysphagia after constrictor muscles definition in head and neck cancer intensitymodulated radiation treatment. / Mazzola, R.; Ricchetti, F.; Fiorentino, A.; Fersino, S.; Giaj Levra, N.; Naccarato, S.; Sicignano, G.; Albanese, S.; Di Paola, G.; Alterio, D.; Ruggieri, R.; Alongi, F.

In: British Journal of Radiology, Vol. 87, No. 1044, 01.12.2014.

Research output: Contribution to journalArticle

Mazzola, R, Ricchetti, F, Fiorentino, A, Fersino, S, Giaj Levra, N, Naccarato, S, Sicignano, G, Albanese, S, Di Paola, G, Alterio, D, Ruggieri, R & Alongi, F 2014, 'Dose-volumerelated dysphagia after constrictor muscles definition in head and neck cancer intensitymodulated radiation treatment', British Journal of Radiology, vol. 87, no. 1044. https://doi.org/10.1259/bjr.20140543
Mazzola, R. ; Ricchetti, F. ; Fiorentino, A. ; Fersino, S. ; Giaj Levra, N. ; Naccarato, S. ; Sicignano, G. ; Albanese, S. ; Di Paola, G. ; Alterio, D. ; Ruggieri, R. ; Alongi, F. / Dose-volumerelated dysphagia after constrictor muscles definition in head and neck cancer intensitymodulated radiation treatment. In: British Journal of Radiology. 2014 ; Vol. 87, No. 1044.
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AU - Fersino, S.

AU - Giaj Levra, N.

AU - Naccarato, S.

AU - Sicignano, G.

AU - Albanese, S.

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AU - Alterio, D.

AU - Ruggieri, R.

AU - Alongi, F.

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