TY - JOUR
T1 - Patterns of long-term swallowing dysfunction after definitive radiotherapy or chemoradiation.
AU - Christianen, M.E.M.C.
AU - Verdonck-de Leeuw, I.M.
AU - Doornaert, P.
AU - Chouvalova, O.
AU - Steenbakkers, R.J.H.M.
AU - Koken, P.W.
AU - Leemans, C.R.
AU - Oosting, S.F.
AU - Roodenburg, J.L.N.
AU - van Laan, B.F.A.M.
AU - Slotman, B.J.
AU - Bijl, H.P.
AU - Langendijk, J.A.
PY - 2015
Y1 - 2015
N2 - Objectives To identify patterns of long-term, radiation-induced swallowing dysfunction after definitive radiotherapy with or without chemotherapy (RT or CHRT) and to determine which factors may explain these patterns over time. Material and methods The study population consisted of 238 consecutive head and neck cancer patients treated with RT or CHRT. The primary endpoint was ≥grade 2 swallowing dysfunction at 6, 12, 18 and 24 months after treatment. Cluster analysis was used to identify different patterns over time. The differences between the mean dose to the swallowing organs at risk for each pattern were determined by using dose maps. Results The cluster analysis revealed five patterns of swallowing dysfunction: low persistent, intermediate persistent, severe persistent, transient and progressive. Patients with high dose to the upper pharyngeal, laryngeal and lower pharyngeal region had the highest risk of severe persistent swallowing dysfunction. Transient problems mainly occurred after high dose to the laryngeal and lower pharyngeal regions, combined with moderate dose to the upper pharyngeal region. The progressive pattern was mainly seen after moderate dose to the upper pharyngeal region. Conclusions Various patterns of swallowing dysfunction after definitive RT or CHRT can be identified over time. This could reflect different underlying biological processes.
AB - Objectives To identify patterns of long-term, radiation-induced swallowing dysfunction after definitive radiotherapy with or without chemotherapy (RT or CHRT) and to determine which factors may explain these patterns over time. Material and methods The study population consisted of 238 consecutive head and neck cancer patients treated with RT or CHRT. The primary endpoint was ≥grade 2 swallowing dysfunction at 6, 12, 18 and 24 months after treatment. Cluster analysis was used to identify different patterns over time. The differences between the mean dose to the swallowing organs at risk for each pattern were determined by using dose maps. Results The cluster analysis revealed five patterns of swallowing dysfunction: low persistent, intermediate persistent, severe persistent, transient and progressive. Patients with high dose to the upper pharyngeal, laryngeal and lower pharyngeal region had the highest risk of severe persistent swallowing dysfunction. Transient problems mainly occurred after high dose to the laryngeal and lower pharyngeal regions, combined with moderate dose to the upper pharyngeal region. The progressive pattern was mainly seen after moderate dose to the upper pharyngeal region. Conclusions Various patterns of swallowing dysfunction after definitive RT or CHRT can be identified over time. This could reflect different underlying biological processes.
U2 - https://doi.org/10.1016/j.radonc.2015.07.042
DO - https://doi.org/10.1016/j.radonc.2015.07.042
M3 - Article
C2 - 26320608
SN - 0167-8140
VL - 117
SP - 139
EP - 144
JO - Radiotherapy and oncology
JF - Radiotherapy and oncology
IS - 1
ER -