Dose-volume response in acute dysphagia toxicity: Validating QUANTEC recommendations into clinical practice for head and neck radiotherapy

Anderson, Nigel; Wada, M.; Schneider-Kolsky, Michal Elisabeth; Rolfo, M.; Joon, Daryl Lim; Khoo, Vincent

doi:10.3109/0284186x.2014.933874

Cited by 13 publications

(19 citation statements)

References 23 publications

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“…However, our dosimetric data showed IMPT plans were able to achieve significantly lower mean doses to several OARs, including the bilateral cochlea, the esophagus, the larynx, the mandible, the oral cavity, and the tongue. This is of high clinical interest because lower doses to these OARs could result in lower incidence of hearing loss, dysphagia, osteonecrosis, mucositis, and dysgeusia …”

Section: Discussionmentioning

confidence: 99%

Intensity‐modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Intensity‐modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes

et al. 2015

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“…Within the group of nine included studies, there were distinct differences in the scope of the papers and as such, two subgroups were identified: (1) studies (n = 5) that aimed purely to assess clinical and functional results following active utilization of swallow structure sparing IMRT and (2) studies (n = 4) that sought to clinically validate NTCP models of dysphagia using patient cohort data that had received some degree of active sparing (which were all from the same Danish group) . As the second group of studies had a different overall purpose in their study design, only the information relevant to the active sparing processes used with their patient cohorts was reviewed for this paper.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies explored outcomes in oropharynx cohorts only while six papers included patients with tumors in the oropharynx, hypopharynx, and/or or nasopharynx (Table ) . One paper did not report on specific sites of disease, stating that recruitment was open to any patient with a squamous cell carcinoma (SCC) of the head and neck. All patients in the included studies were treated with IMRT, with concurrent chemotherapy regimens used in six studies .…”

Section: Resultsmentioning

confidence: 99%

“…All patients in the included studies were treated with IMRT, with concurrent chemotherapy regimens used in six studies . The remaining three studies reported on patients who received radiotherapy only or did not provide detail regarding systemic therapy delivered…”

Section: Resultsmentioning

confidence: 99%

“…As such, the decision was made to include these papers. Therefore, a total of nine studies were included in the final review and are summarized in Table .…”

Section: Methodsmentioning

confidence: 99%

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Dysphagia optimized radiotherapy to reduce swallowing dysfunction severity in patients undergoing treatment for head and neck cancer: A systematized scoping review

et al. 2019

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This study involved a systematized scoping review to coalesce current evidence on dysphagia outcomes achieved through active sparing of the swallowing structures in patients receiving radiotherapy for head and neck cancer. Eligible publications between 2007 and 2017 were reviewed and synthesized regarding participant demographics, treatment regimens, swallowing structures chosen for optimization, dosimetric constraints, and dysphagia measures. Nine prospective cohort studies were included. Key structures routinely spared included pharyngeal constrictor muscles (PCMs), glottic larynx (GL), supraglottic larynx (SGL), and esophageal inlet muscle. Shorter enteral feeding times and reductions in Common Terminology Criteria for Adverse Event (CTCAE) grade 3 dysphagia toxicity were observed when dose to the larynx (GL and SGL) and PCMs was constrained to < 50 and < 60 Gy, respectively. Emerging evidence supports “active” sparing of the swallowing structures at the time of radiotherapy planning to reduce dysphagia severity, with no compromise to planning target volumes and locoregional control rates.

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Systematic review and meta‐analysis of the impact of dosimetry to dysphagia and aspiration related structures

et al. 2019

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Background Technological advances in radiotherapy have allowed investigations into new methods to spare healthy tissue in those treated for head and neck cancer. This systematic review with meta‐analysis demonstrates the effect that radiation has on swallowing. Methods Selection and analysis of studies examining the effect of radiation to swallowing structures. A fixed effects meta‐analysis calculated the pooled proportions for select outcomes of dysphagia, common across many studies. Results The majority of the papers found a correlation between radiation dose to the swallowing structures and dysphagia, however a meta‐analysis found the studies carried a significant degree of heterogeneity. The appraisal demonstrates the need for large‐scale studies using a randomized design and instrumental dysphagia assessments. Conclusions Radiation dose to dysphagia and aspiration structures is correlated with incidence of dysphagia and aspiration. The variables in this population contribute to the heterogeneity within and cross studies and future studies should consider controlling for this.

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Dose-volume response in acute dysphagia toxicity: Validating QUANTEC recommendations into clinical practice for head and neck radiotherapy

Cited by 13 publications

References 23 publications

Intensity‐modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes

Intensity‐modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes

Dysphagia optimized radiotherapy to reduce swallowing dysfunction severity in patients undergoing treatment for head and neck cancer: A systematized scoping review

Systematic review and meta‐analysis of the impact of dosimetry to dysphagia and aspiration related structures

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