Intensity modulated radiotherapy (IMRT) in the management of locally advanced oropharyngeal squamous cell carcinomata (SCC): disease control and functional outcome using the therapy outcome measure (TOM) score - report from a single U.K. institution

Ingle, C.; Yip, K.; Caskie, Valerie; Dyson, Catherine; Ford, Amanda; Scrase, Christopher

doi:10.1186/1758-3284-2-28

Cited by 9 publications

(14 citation statements)

References 30 publications

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“…The majority included a combination of surgery, RT, and chemotherapy . Few included patients treated with definitive RT +/− chemotherapy without surgery and only one reported RT alone (hyperfractionated) .…”

Section: Resultsmentioning

confidence: 99%

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Prevalence of trismus in patients with head and neck cancer: A systematic review with meta‐analysis

et al. 2019

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Background The purpose of this systematic review and meta‐analysis was to determine the prevalence of trismus in patients with head and neck cancer. Methods Four electronic databases were searched: Cochrane Library, MEDLINE, EMBASE, and Web of Science up to April 2018. Level of evidence was assessed based on Oxford Centre for Evidence‐based Medicine. Publications were restricted to prospective cohort studies (n = 15), randomized clinical trials (n = 3), and cross‐sectional studies (n = 5) reporting on trismus as mouth maximum opening less than or equal to 35 mm in the English language. Results A total of 636 abstracts were reviewed for inclusion. Twenty‐three studies were included in qualitative analysis and 15 studies in meta‐analysis. The results included 2786 patients with head and neck cancer treated with surgery, radiotherapy, and/or chemotherapy either alone or in combination. Based on meta‐analyses, the weighted average prevalence of trismus increased from 17.3% at baseline (95% confidence interval [CI], 10.8%‐26.5%) to a peak of 44.1% at 6 months (95% CI, 36.7%‐51.8%) and decreased to 32.1% at 12 months (95% CI, 27.2%‐37.4%) and continued in average 32.6% at 3‐10 years (95% CI, 22.0%‐45.3%). Conclusions Having a primary site of the oral cavity or oropharynx was associated with a higher risk for developing trismus based on individual studies. Prospective cohort studies or randomized controlled trials with multiple objective trismus measurements, evaluation of disease characteristics, and treatment variables are needed to further investigate the prevalence of trismus secondary to head and neck cancer treatment.

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Section: Resultsmentioning

confidence: 99%

“…Of those 23 studies, 15 studies could be included in the meta-analyses as described above. 25,32,37,38,[40][41][42][43]47,[49][50][51][53][54][55]…”

Section: Included Studiesmentioning

confidence: 99%

Prevalence of trismus in patients with head and neck cancer: A systematic review with meta‐analysis

et al. 2019

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“…Reported incidences of trismus in oral and oropharyngeal cancer patients treated with IMRT can range from 4% to 77.3% (Hsieh et al, 2014; Rao et al, 2015; Ingle et al, 2010; Chao et al, 2004; Gomez et al, 2009). This wide range is likely due to different inclusion criteria; subjective or objective assessments of trismus, cut-off values for trismus, and follow-up periods.…”

Section: Introductionmentioning

confidence: 99%

Objective assessment of trismus in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT)

Owosho

Ramalho

Rosenberg

et al. 2016

Journal of Cranio-Maxillofacial Surgery

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Purpose The aim of this study was to estimate the incidence of trismus in oral and oropharyngeal cancer patients (OOPC) treated with intensity-modulated radiation therapy (IMRT) and to identify the role of risk factors in patients who developed trismus. Materials and Methods A retrospective cohort study of OOPC treated with IMRT in our institution from 2009 through 2014 was performed. Patients eligible for this study had pre-RT and post-RT maximal inter-incisal opening (MIO) measurements at 6 – 48 months post-RT, treated with high-dose radiation (≥60 Gy) and pre-RT MIO ≥ 36 mm. A descriptive analysis to identify the incidence of trismus, with trismus stated as MIO ≤ 35 mm at or after 6 months post-RT measurement was performed. The role of risk factors such as age, gender, tumor site, tumor size (T), tumor stage, pre-RT MIO measurements and radiation dose to the tumor were assessed using Fisher exact test and the radiation doses to the ipsilateral muscles of mastication in patients who developed trismus were assessed by matching with control (non-trismus) patients using Wilcoxon Signed Rank test. Results The study consisted of 54 patients with a median age of 55 years and 81% were males. The median follow-up time was 10 months. The incidence of trismus was 14.8%. Patients with pre-RT MIO measurements ≤40 mm were at risk of developing trismus (P<0.001). In trismus patients, the average mean radiation dose to the masseter and medial pterygoid muscles was numerically higher but not significantly different (P=0.08; P=0.22, respectively) to matched control patients. Age, gender, radiation dose to the tumor, tumor site, size (T) and stage were also found to be not significant. Conclusion Pre-RT MIO measurement was a significant risk factor for the development of trismus. However, this is a non-modifiable factor. Limiting radiation dose to the muscles of mastication could prevent this complication.

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“…Ingle et al 62 -RBHOMS Myers et al 31 Cartmill et al 25 -MD Anderson Dysphagia Inventory O'Hara et al 15 Prestwich et al 34 Kendall et al 33 More et al 13 Cartmill et al 25 Hutcheson et al 32 Schwartz et al 29 Levendag et al 30 Gillespie et al 26 O'Hara et al 15 De Almeida et al 37 Lee et al 22 More et al 13 Sinclair et al 38 Iseli et al 39 Functional Outcome Swallowing Scale -Park et al 35 Yamashita et al 36 Haughey et al 19 Moore et al 40 Grant et al 20…”

Section: Tom Score (Disability Domain)mentioning

confidence: 99%

Functional swallowing outcomes following treatment for oropharyngeal carcinoma: a systematic review of the evidence comparing trans‐oral surgery versus non‐surgical management

Dawe¹,

Patterson

O’Hara

2016

Clinical Otolaryngology

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From the current evidence, no direct comparisons could be made of swallowing outcomes between the surgical and non-surgical modalities. Swallowing is a multidimensional construct, and the range of assessments utilised by authors reflects the variety of available reporting methods. The MD Anderson Dysphagia Inventory is a subjective measure that allows limited comparison between the currently available heterogeneous data, and is explored in detail. The findings highlight that further research may identify the most appropriate tools for measuring swallowing in patients with OPSCC. Consensus should allow their standardised integration into future studies and randomised control trials.

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Intensity modulated radiotherapy (IMRT) in the management of locally advanced oropharyngeal squamous cell carcinomata (SCC): disease control and functional outcome using the therapy outcome measure (TOM) score - report from a single U.K. institution

Cited by 9 publications

References 30 publications

Prevalence of trismus in patients with head and neck cancer: A systematic review with meta‐analysis

Prevalence of trismus in patients with head and neck cancer: A systematic review with meta‐analysis

Objective assessment of trismus in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT)

Functional swallowing outcomes following treatment for oropharyngeal carcinoma: a systematic review of the evidence comparing trans‐oral surgery versus non‐surgical management

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