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Dysphagia - Results from multivariable predictive modelling on aspiration from a subset of the ARTSCAN trial
Umea Univ, Umea Univ Hosp, Dept Radiat Sci, Oncol, Umea, Sweden..
Lund Univ, Skane Univ Hosp, Dept Oncol & Radiat Phys, S-22100 Lund, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Umea Univ, Umea Univ Hosp, Dept Radiat Sci, Oncol, Umea, Sweden..
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2017 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 122, no 2, 192-199 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: To establish predictive models for late objective aspiration and late patient-reported choking based on dose-volume parameters and baseline patient and treatment characteristics, for patients with head and neck cancer undergoing definitive radiotherapy (RT). The impact of electively treated volume on late aspiration was also investigated. Methods and material: This prospective cohort is a subsample of 124 survivors from the ARTSCAN study. Late aspiration was identified with videofluoroscopy, at a minimum of 25 months after the start of RT. Patient-reported choking was analysed at 12 and 60 months post RT using the EORTC Quality of Life Module for Head and Neck Cancer 35. Univariable and multivariable analyses were performed to describe the association between clinical factors and dose-volume descriptors for organs at risk (OARs) and late dysphagia. Results: Aspiration was found in 47% of the eligible patients. Mean dose to the middle pharyngeal constrictor (MPC), neck dissection post RT and age at randomisation in ARTSCAN were associated to late aspiration. Mean dose to the superior pharyngeal constrictor (SPC) and swallowing complaints at baseline were associated to patient reported choking at both time-points. Conclusions: Three separate risk groups for late aspiration, and two risk groups for late patient-reported choking were identified based on number of risk factors. The size of the electively treated volume could be used as a surrogate for individual OARs predicting late aspiration.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2017. Vol. 122, no 2, 192-199 p.
Keyword [en]
Head and neck cancer, Radiotherapy, Dysphagia, Normal tissue complication probability
National Category
Cancer and Oncology Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:uu:diva-320781DOI: 10.1016/j.radonc.2016.09.001ISI: 000395607300004PubMedID: 27687824OAI: oai:DiVA.org:uu-320781DiVA: diva2:1090757
Funder
Swedish Cancer SocietyCancer and Allergy Foundation
Available from: 2017-04-25 Created: 2017-04-25 Last updated: 2017-04-25Bibliographically approved

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