Radiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis

Abstract Dysphagia is a side effect of nasopharyngeal carcinoma chemo-radiotherapy (CRT) which greatly influences the quality of life of the patients. We analyzed late dysphagia in 134 patients with nasopharyngeal cancer undergoing radical radiotherapy (RT), and correlated these findings with dose–v...

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Autores principales:	Li Jiang, Chenhui Huang, Yixiu Gan, Tong Wu, Xiaobi Tang, Yiru Wang, Rensheng Wang, Yong Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Late Dysphagia Nasopharyngeal Carcinoma (NPC) M.D. Anderson Dysphagia Inventory (MDADI) Inferior Constrictor Muscle (ICM) Superior Constrictor Muscle (SCM) Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6d57b5dd7511484f99bb1a6f063e796b
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spelling	oai:doaj.org-article:6d57b5dd7511484f99bb1a6f063e796b2021-12-02T15:08:16ZRadiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis10.1038/s41598-018-34803-y2045-2322https://doaj.org/article/6d57b5dd7511484f99bb1a6f063e796b2018-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-34803-yhttps://doaj.org/toc/2045-2322Abstract Dysphagia is a side effect of nasopharyngeal carcinoma chemo-radiotherapy (CRT) which greatly influences the quality of life of the patients. We analyzed late dysphagia in 134 patients with nasopharyngeal cancer undergoing radical radiotherapy (RT), and correlated these findings with dose–volume histogram (DVH) parameters of the swallowing organs at risk (SWOARs). DVH parameters of SWOARs were correlated with late dysphagia, and with RTOG/EORTC scale score and the M. D. Anderson dysphagia inventory (MDADI) score. The mean dose (Dmean) to the superior and inferior constrictor muscles (SCM and ICM) and age were associated with grade 2 late dysphagia. Receiver operating characteristic (ROC) curves showed that the threshold values for grade 2 late dysphagia were: Dmean to SCM ≥ 67 Gy, partial volume receiving specified dose of 60 Gy (V60) of SCM ≥ 95%, Dmean to ICM ≥ 47 Gy, and V50 of ICM ≥ 23%. The areas under the ROC curve were 0.681 (p = 0.02), 0.677 (p = 0.002), 0.71 (p < 0.001) and 0.726 (p < 0.001) respectively. Our study demonstrates a significant relationship between late dysphagia and the radiation doses delivered to the SCM and ICM. Our findings suggest that physicians should be cautious in reducing the RT dose to SWOARs in order to avoid severe dysphagia. Further prospective trials are necessary to recommend this as part of routine clinical practice.Li JiangChenhui HuangYixiu GanTong WuXiaobi TangYiru WangRensheng WangYong ZhangNature PortfolioarticleLate DysphagiaNasopharyngeal Carcinoma (NPC)M.D. Anderson Dysphagia Inventory (MDADI)Inferior Constrictor Muscle (ICM)Superior Constrictor Muscle (SCM)MedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-8 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Late Dysphagia Nasopharyngeal Carcinoma (NPC) M.D. Anderson Dysphagia Inventory (MDADI) Inferior Constrictor Muscle (ICM) Superior Constrictor Muscle (SCM) Medicine R Science Q
spellingShingle	Late Dysphagia Nasopharyngeal Carcinoma (NPC) M.D. Anderson Dysphagia Inventory (MDADI) Inferior Constrictor Muscle (ICM) Superior Constrictor Muscle (SCM) Medicine R Science Q Li Jiang Chenhui Huang Yixiu Gan Tong Wu Xiaobi Tang Yiru Wang Rensheng Wang Yong Zhang Radiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis
description	Abstract Dysphagia is a side effect of nasopharyngeal carcinoma chemo-radiotherapy (CRT) which greatly influences the quality of life of the patients. We analyzed late dysphagia in 134 patients with nasopharyngeal cancer undergoing radical radiotherapy (RT), and correlated these findings with dose–volume histogram (DVH) parameters of the swallowing organs at risk (SWOARs). DVH parameters of SWOARs were correlated with late dysphagia, and with RTOG/EORTC scale score and the M. D. Anderson dysphagia inventory (MDADI) score. The mean dose (Dmean) to the superior and inferior constrictor muscles (SCM and ICM) and age were associated with grade 2 late dysphagia. Receiver operating characteristic (ROC) curves showed that the threshold values for grade 2 late dysphagia were: Dmean to SCM ≥ 67 Gy, partial volume receiving specified dose of 60 Gy (V60) of SCM ≥ 95%, Dmean to ICM ≥ 47 Gy, and V50 of ICM ≥ 23%. The areas under the ROC curve were 0.681 (p = 0.02), 0.677 (p = 0.002), 0.71 (p < 0.001) and 0.726 (p < 0.001) respectively. Our study demonstrates a significant relationship between late dysphagia and the radiation doses delivered to the SCM and ICM. Our findings suggest that physicians should be cautious in reducing the RT dose to SWOARs in order to avoid severe dysphagia. Further prospective trials are necessary to recommend this as part of routine clinical practice.
format	article
author	Li Jiang Chenhui Huang Yixiu Gan Tong Wu Xiaobi Tang Yiru Wang Rensheng Wang Yong Zhang
author_facet	Li Jiang Chenhui Huang Yixiu Gan Tong Wu Xiaobi Tang Yiru Wang Rensheng Wang Yong Zhang
author_sort	Li Jiang
title	Radiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis
title_short	Radiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis
title_full	Radiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis
title_fullStr	Radiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis
title_full_unstemmed	Radiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis
title_sort	radiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/6d57b5dd7511484f99bb1a6f063e796b
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Radiation-induced late dysphagia after intensity-modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume effect analysis

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