Strahleninduzierte akute Dysphagie

Prospektive Beobachtungsstudie an 42 Kopf-Hals-Malignompatienten

Translated title of the contribution: Radiation-induced acute dysphagia: Prospective observational study on 42 head and neck cancer patients

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: Acute toxicity in head and neck (H&N) cancer patients treated with definitive radiotherapy (RT) has a crucial role in compliance to treatments. The aim of this study was to correlate doses to swallowing-associated structures and acute dysphagia. Methods: We prospectively analyzed 42 H&N cancer patients treated with RT. Dysphagia (grade ≥ 3) and indication for percutaneous endoscopic gastrostomy (PEG) insertion were classified as acute toxicity. Ten swallowing-related structures were considered for the dosimetric analysis. The correlation between clinical information and the dose absorbed by the contoured structures was analyzed. Multivariate logistic regression method using resampling methods (bootstrapping) was applied to select model order and parameters for normal tissue complication probability (NTCP) modelling. Results: A strong multiple correlation between dosimetric parameters was found. A two-variable model was suggested as the optimal order by bootstrap method. The optimal model (Rs = 0.452, p < 0.001) includes V45 of the cervical esophagus (odds ratio [OR] = 1.016) and Dmean of the cricopharyngeal muscle (OR = 1.057). The model area under the curve was 0.82 (95% confidence interval 0.69–0.95). Conclusion: Our results suggested that the absorbed dose to the cricopharyngeal muscle and cervical esophagus might play a relevant role in the development of acute RT-related dysphagia.

Original languageGerman
Pages (from-to)971-981
Number of pages11
JournalStrahlentherapie und Onkologie
Volume193
Issue number11
DOIs
Publication statusPublished - Nov 1 2017

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Head and Neck Neoplasms
Deglutition Disorders
Observational Studies
Prospective Studies
Radiation
Radiotherapy
Deglutition
Esophagus
Odds Ratio
Muscles
Gastrostomy
Area Under Curve
Neck
Logistic Models
Head
Confidence Intervals
Neoplasms
Therapeutics

Keywords

  • Acute toxicity
  • Cricopharyngeal muscle
  • Esophagus
  • Radiotherapy
  • Swallowing defects

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology

Cite this

@article{8a9d56c275ed495fb6d3bc517c21d980,
title = "Strahleninduzierte akute Dysphagie: Prospektive Beobachtungsstudie an 42 Kopf-Hals-Malignompatienten",
abstract = "Purpose: Acute toxicity in head and neck (H&N) cancer patients treated with definitive radiotherapy (RT) has a crucial role in compliance to treatments. The aim of this study was to correlate doses to swallowing-associated structures and acute dysphagia. Methods: We prospectively analyzed 42 H&N cancer patients treated with RT. Dysphagia (grade ≥ 3) and indication for percutaneous endoscopic gastrostomy (PEG) insertion were classified as acute toxicity. Ten swallowing-related structures were considered for the dosimetric analysis. The correlation between clinical information and the dose absorbed by the contoured structures was analyzed. Multivariate logistic regression method using resampling methods (bootstrapping) was applied to select model order and parameters for normal tissue complication probability (NTCP) modelling. Results: A strong multiple correlation between dosimetric parameters was found. A two-variable model was suggested as the optimal order by bootstrap method. The optimal model (Rs = 0.452, p < 0.001) includes V45 of the cervical esophagus (odds ratio [OR] = 1.016) and Dmean of the cricopharyngeal muscle (OR = 1.057). The model area under the curve was 0.82 (95{\%} confidence interval 0.69–0.95). Conclusion: Our results suggested that the absorbed dose to the cricopharyngeal muscle and cervical esophagus might play a relevant role in the development of acute RT-related dysphagia.",
keywords = "Acute toxicity, Cricopharyngeal muscle, Esophagus, Radiotherapy, Swallowing defects",
author = "D. Alterio and Gerardi, {M. A.} and L. Cella and R. Spoto and V. Zurlo and A. Sabbatini and C. Fodor and V. D’Avino and M. Conson and F. Valoriani and D. Ciardo and R. Pacelli and A. Ferrari and P. Maisonneuve and L. Preda and R. Bruschini and {Cossu Rocca}, M. and E. Rondi and S. Colangione and G. Palma and S. Dicuonzo and R. Orecchia and G. Sanguineti and Jereczek-Fossa, {B. A.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1007/s00066-017-1206-x",
language = "Tedesco",
volume = "193",
pages = "971--981",
journal = "Strahlentherapie und Onkologie",
issn = "0179-7158",
publisher = "Urban und Vogel",
number = "11",

}

TY - JOUR

T1 - Strahleninduzierte akute Dysphagie

T2 - Prospektive Beobachtungsstudie an 42 Kopf-Hals-Malignompatienten

AU - Alterio, D.

AU - Gerardi, M. A.

AU - Cella, L.

AU - Spoto, R.

AU - Zurlo, V.

AU - Sabbatini, A.

AU - Fodor, C.

AU - D’Avino, V.

AU - Conson, M.

AU - Valoriani, F.

AU - Ciardo, D.

AU - Pacelli, R.

AU - Ferrari, A.

AU - Maisonneuve, P.

AU - Preda, L.

AU - Bruschini, R.

AU - Cossu Rocca, M.

AU - Rondi, E.

AU - Colangione, S.

AU - Palma, G.

AU - Dicuonzo, S.

AU - Orecchia, R.

AU - Sanguineti, G.

AU - Jereczek-Fossa, B. A.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Purpose: Acute toxicity in head and neck (H&N) cancer patients treated with definitive radiotherapy (RT) has a crucial role in compliance to treatments. The aim of this study was to correlate doses to swallowing-associated structures and acute dysphagia. Methods: We prospectively analyzed 42 H&N cancer patients treated with RT. Dysphagia (grade ≥ 3) and indication for percutaneous endoscopic gastrostomy (PEG) insertion were classified as acute toxicity. Ten swallowing-related structures were considered for the dosimetric analysis. The correlation between clinical information and the dose absorbed by the contoured structures was analyzed. Multivariate logistic regression method using resampling methods (bootstrapping) was applied to select model order and parameters for normal tissue complication probability (NTCP) modelling. Results: A strong multiple correlation between dosimetric parameters was found. A two-variable model was suggested as the optimal order by bootstrap method. The optimal model (Rs = 0.452, p < 0.001) includes V45 of the cervical esophagus (odds ratio [OR] = 1.016) and Dmean of the cricopharyngeal muscle (OR = 1.057). The model area under the curve was 0.82 (95% confidence interval 0.69–0.95). Conclusion: Our results suggested that the absorbed dose to the cricopharyngeal muscle and cervical esophagus might play a relevant role in the development of acute RT-related dysphagia.

AB - Purpose: Acute toxicity in head and neck (H&N) cancer patients treated with definitive radiotherapy (RT) has a crucial role in compliance to treatments. The aim of this study was to correlate doses to swallowing-associated structures and acute dysphagia. Methods: We prospectively analyzed 42 H&N cancer patients treated with RT. Dysphagia (grade ≥ 3) and indication for percutaneous endoscopic gastrostomy (PEG) insertion were classified as acute toxicity. Ten swallowing-related structures were considered for the dosimetric analysis. The correlation between clinical information and the dose absorbed by the contoured structures was analyzed. Multivariate logistic regression method using resampling methods (bootstrapping) was applied to select model order and parameters for normal tissue complication probability (NTCP) modelling. Results: A strong multiple correlation between dosimetric parameters was found. A two-variable model was suggested as the optimal order by bootstrap method. The optimal model (Rs = 0.452, p < 0.001) includes V45 of the cervical esophagus (odds ratio [OR] = 1.016) and Dmean of the cricopharyngeal muscle (OR = 1.057). The model area under the curve was 0.82 (95% confidence interval 0.69–0.95). Conclusion: Our results suggested that the absorbed dose to the cricopharyngeal muscle and cervical esophagus might play a relevant role in the development of acute RT-related dysphagia.

KW - Acute toxicity

KW - Cricopharyngeal muscle

KW - Esophagus

KW - Radiotherapy

KW - Swallowing defects

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U2 - 10.1007/s00066-017-1206-x

DO - 10.1007/s00066-017-1206-x

M3 - Articolo

VL - 193

SP - 971

EP - 981

JO - Strahlentherapie und Onkologie

JF - Strahlentherapie und Onkologie

SN - 0179-7158

IS - 11

ER -