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  • Title: Risk factors for severe Dysphagia after concurrent chemoradiotherapy for head and neck cancers.
    Author: Koiwai K, Shikama N, Sasaki S, Shinoda A, Kadoya M.
    Journal: Jpn J Clin Oncol; 2009 Jul; 39(7):413-7. PubMed ID: 19383615.
    Abstract:
    OBJECTIVE: The aim of this study was to investigate the risk factors for dysphagia induced by chemoradiotherapy for head and neck cancers. METHODS: Forty-seven patients with head and neck cancers who underwent definitive chemoradiotherapy from December 1998 to March 2006 were reviewed retrospectively. Median age was 63 years (range, 16-81). The locations of the primary lesion were as follows: larynx in 18 patients, oropharynx in 11, nasopharynx in 7, hypopharynx in 7 and others in 4. Clinical stages were as follows: Stage II in 20 and Stages III-IV in 27. Almost all patients underwent platinum-based concomitant chemoradiotherapy. The median cumulative dose of cisplatin was 100 mg/m(2) (range, 80-300) and median radiation dose was 70 Gy (range, 50-70). RESULTS: Severe dysphagia (Grade 3-4) was observed in 22 patients (47%) as an acute toxic event. One patient required tube feeding even at 12-month follow-up. In univariate analysis, clinical stage (III-IV) (P = 0.017), primary site (oro-hypopharynx) (P = 0.041) and radiation portal size (>11 cm) (P < 0.001) were found to be associated with severe dysphagia. In multivariate analysis, only radiation portal size was found to have a significant relationship with severe dysphagia (P = 0.048). CONCLUSIONS: Larger radiation portal field was associated with severe dysphagia induced by chemoradiotherapy.
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