Predictors of Patient-Reported Dysphagia Following IMRT Plus Chemotherapy in Oropharyngeal Cancer

Ester Orlandi, Rosalba Miceli, Gabriele Infante, Aurora Mirabile, Daniela Alterio, Maria Cossu Rocca, Nerina Denaro, Riccardo Vigna-Taglianti, Annamaria Merlotti, Antonio Schindler, Nicole Pizzorni, Carlo Fallai, Lisa Licitra, Paolo Bossi

Research output: Contribution to journalArticlepeer-review

Abstract

The aim of this cross-sectional study is to evaluate the factors associated with patient-reported dysphagia in patients affected by locally advanced oropharyngeal cancer (OPC) treated with definitive intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy (CHT), with or without induction CHT. We evaluated 148 OPC patients treated with IMRT and concurrent CHT, without evidence of disease and who had completed their treatment since at least 6 months. At their planned follow-up visit, patients underwent clinical evaluation and completed the M.D. Anderson dysphagia inventory (MDADI) questionnaire. The association between questionnaire composite score (MDADI-CS) and different patients’ and tumor’s characteristics and treatments (covariates) was investigated by univariable and multivariable analyses, the latter including only covariates significant at univariable analysis. With a median time from treatment end of 30 months [range 6–74 months, interquartile range (IQR) 16–50 months], the median (IQR) MDADI-CS was 72 (63–84). The majority of patients (82.4%) had a MDADI-CS ≥ 60. At multivariable analysis, female gender, human papilloma virus (HPV)-negative status, and moderate and severe clinician-rated xerostomia were significantly associated with lower MDADI-CS. Patient-perceived dysphagia was satisfactory or acceptable in the majority of patients. HPV status and xerostomia were confirmed as important predictive factors for swallowing dysfunction after radiochemotherapy. Data regarding female gender are new and deserve further investigation.

Original languageEnglish
Pages (from-to)52-62
Number of pages11
JournalDysphagia
Volume34
Issue number1
DOIs
Publication statusPublished - Feb 15 2019

Keywords

  • Human papilloma virus
  • Long-term dysphagia
  • MDADI score
  • Oropharyngeal carcinoma
  • Xerostomia

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Gastroenterology
  • Speech and Hearing

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