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09.07.2018 | Original Article

Pattern of dysphagia after swallowing-sparing intensity-modulated radiotherapy (IMRT) of head and neck cancers: results of a mono-institutional prospective study

verfasst von: Stefano Ursino, MD, Paola Cocuzza, Veronica Seccia, Durim Delishaj, Agostino Cristaudo, Francesco Pasqualetti, Patrizia Giusti, Stefania Santopadre, Riccardo Morganti, Francesco Fiorica, Fabiola Paiar, Bruno Fattori

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 12/2018

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Abstract

Background and purpose

A prospective instrumental assessment of late dysphagia using swallowing organs at risk (SWOARs)-sparing IMRT for nasopharyngeal and oropharyngeal cancers.

Materials and methods

Objective instrumental assessment included fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy (VFS) at baseline, and at 6 and 12 months after treatment. FEES assessed the pharyngeal residue according to the Farneti pooling score (P-score) as follows: 4–5 no dysphagia; 6–7 mild dysphagia; 8–9 moderate dysphagia; 10–11 severe dysphagia. Three different consistencies were tested for the P‑score: liquid (L), semisolid (SS), and solid (S). VFS assessed penetration-aspiration according to the Penetration-Aspiration Scale (PAS) and two different consistencies of the bolus were tested: thin liquid barium (L) and paste barium (S).

Results

38 patients were evaluable. There was a significant worsening of the P‑score at 6 months both for SS (p = 0.015) and S (p < 0.001), which persisted only for S at 12 months (p < 0.0001). Similarly, there was a significant worsening of the PAS score at 6 and 12 months (p = 0.065 and 0.039, respectively) for the S bolus. Overall, 3–7 and 10–14% aspiration after L and S was observed, respectively.

Conclusions

Promising results using a SWOARs-sparing IMRT technique are reported. Therefore, treatment plans should be optimized for reducing doses to these structures.

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Titel: Pattern of dysphagia after swallowing-sparing intensity-modulated radiotherapy (IMRT) of head and neck cancers: results of a mono-institutional prospective study
verfasst von: Stefano Ursino, MD
Paola Cocuzza
Veronica Seccia
Durim Delishaj
Agostino Cristaudo
Francesco Pasqualetti
Patrizia Giusti
Stefania Santopadre
Riccardo Morganti
Francesco Fiorica
Fabiola Paiar
Bruno Fattori
Publikationsdatum: 09.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 12/2018
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1328-9

Springer Medizin

Pattern of dysphagia after swallowing-sparing intensity-modulated radiotherapy (IMRT) of head and neck cancers: results of a mono-institutional prospective study