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

E. Orlandi, R. Miceli, G. Infante, A. Mirabile, D. Alterio, M. Cossu Rocca, N. Denaro, R. Vigna-Taglianti, A. Merlotti, A. Schindler, N. Pizzorni, C. Fallai, L. Licitra, P. Bossi

Research output: Contribution to journalArticlepeer-review


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. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
Original languageEnglish
Pages (from-to)52-62
Number of pages11
Issue number1
Publication statusPublished - 2019


  • Human papilloma virus
  • Long-term dysphagia
  • MDADI score
  • Oropharyngeal carcinoma
  • Xerostomia
  • adult
  • Article
  • cancer chemotherapy
  • clinical evaluation
  • cross-sectional study
  • disease association
  • dysphagia
  • female
  • follow up
  • gender
  • human
  • induction chemotherapy
  • intensity modulated radiation therapy
  • major clinical study
  • male
  • oropharynx cancer
  • Papillomaviridae
  • patient-reported outcome
  • priority journal
  • questionnaire
  • xerostomia
  • aged
  • chemoradiotherapy
  • evaluation study
  • middle aged
  • multivariate analysis
  • oropharynx tumor
  • radiation injury
  • risk factor
  • sex factor
  • Aged
  • Chemoradiotherapy
  • Cross-Sectional Studies
  • Deglutition Disorders
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Oropharyngeal Neoplasms
  • Patient Reported Outcome Measures
  • Radiation Injuries
  • Radiotherapy, Intensity-Modulated
  • Risk Factors
  • Sex Factors
  • Surveys and Questionnaires


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