Risk Factors for Severe Dysphagia after Concurrent Chemoradiotherapy for Head and Neck Cancers
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....
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| Veröffentlicht in: | Japanese journal of clinical oncology 2009-07, Vol.39 (7), p.413-417 |
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| creator | Koiwai, Keiichiro Shikama, Naoto Sasaki, Shigeru Shinoda, Atsunori Kadoya, Masumi |
| description | 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/m2 (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. |
| doi_str_mv | 10.1093/jjco/hyp033 |
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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/m2 (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.</description><identifier>ISSN: 0368-2811</identifier><identifier>EISSN: 1465-3621</identifier><identifier>DOI: 10.1093/jjco/hyp033</identifier><identifier>PMID: 19383615</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Carcinoma, Squamous Cell - drug therapy ; Carcinoma, Squamous Cell - radiotherapy ; Carcinoma, Squamous Cell - secondary ; Cisplatin - administration & dosage ; Combined Modality Therapy ; Deglutition Disorders - diagnosis ; Deglutition Disorders - etiology ; Deglutition Disorders - therapy ; dysphagia ; Female ; Fluorouracil - administration & dosage ; head and neck neoplasm ; Head and Neck Neoplasms - drug therapy ; Head and Neck Neoplasms - pathology ; Head and Neck Neoplasms - radiotherapy ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; radiotherapy ; Radiotherapy Dosage ; Radiotherapy, Conformal - adverse effects ; Retrospective Studies ; Risk Factors ; Survival Rate ; toxicity ; Treatment Outcome ; Young Adult</subject><ispartof>Japanese journal of clinical oncology, 2009-07, Vol.39 (7), p.413-417</ispartof><rights>The Author (2009). Published by Oxford University Press. All rights reserved 2009</rights><rights>The Author (2009). Published by Oxford University Press. All rights reserved</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c488t-3b784fe6effd458a56b85126fbbe9d9af43d17602e00dd57a2c1e154e8d5883d3</citedby><cites>FETCH-LOGICAL-c488t-3b784fe6effd458a56b85126fbbe9d9af43d17602e00dd57a2c1e154e8d5883d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19383615$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koiwai, Keiichiro</creatorcontrib><creatorcontrib>Shikama, Naoto</creatorcontrib><creatorcontrib>Sasaki, Shigeru</creatorcontrib><creatorcontrib>Shinoda, Atsunori</creatorcontrib><creatorcontrib>Kadoya, Masumi</creatorcontrib><title>Risk Factors for Severe Dysphagia after Concurrent Chemoradiotherapy for Head and Neck Cancers</title><title>Japanese journal of clinical oncology</title><addtitle>Jpn J Clin Oncol</addtitle><description>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/m2 (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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Carcinoma, Squamous Cell - drug therapy</subject><subject>Carcinoma, Squamous Cell - radiotherapy</subject><subject>Carcinoma, Squamous Cell - secondary</subject><subject>Cisplatin - administration & dosage</subject><subject>Combined Modality Therapy</subject><subject>Deglutition Disorders - diagnosis</subject><subject>Deglutition Disorders - etiology</subject><subject>Deglutition Disorders - therapy</subject><subject>dysphagia</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>head and neck neoplasm</subject><subject>Head and Neck Neoplasms - drug therapy</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Head and Neck Neoplasms - radiotherapy</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>radiotherapy</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Conformal - adverse effects</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><subject>toxicity</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0368-2811</issn><issn>1465-3621</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0M1P2zAYx3Fr2gSFceKOrB24oICfOHacIwovRaqYtDchDrOc-PGado2DnUz0v6clFRx38uXj3yN9CTkGdg6s4BeLRe0v5uuOcf6BTCCTIuEyhY9kwrhUSaoA9slBjAvGmFBZvkf2oeCKSxAT8vtbE5f0xtS9D5E6H-h3_IcB6dU6dnPzpzHUuB4DLX1bDyFg29NyjisfjG18P8dguvXrvykaS01r6T3WS1qatsYQP5NPzvyNeLR7D8nPm-sf5TSZfb29Ky9nSZ0p1Se8ylXmUKJzNhPKCFkpAal0VYWFLYzLuIVcshQZs1bkJq0BQWSorFCKW35Ivoy7XfBPA8ZeL_wQ2s1JnUIOwItCbdDZiOrgYwzodBealQlrDUxvU-ptSj2m3OiT3eRQrdC-2127DTgdgR-6_ywlI2xij89v1ISlljnPhZ4-POpHuFfZQzHVv_gLPaONBg</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Koiwai, Keiichiro</creator><creator>Shikama, Naoto</creator><creator>Sasaki, Shigeru</creator><creator>Shinoda, Atsunori</creator><creator>Kadoya, Masumi</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope></search><sort><creationdate>20090701</creationdate><title>Risk Factors for Severe Dysphagia after Concurrent Chemoradiotherapy for Head and Neck Cancers</title><author>Koiwai, Keiichiro ; Shikama, Naoto ; Sasaki, Shigeru ; Shinoda, Atsunori ; Kadoya, Masumi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c488t-3b784fe6effd458a56b85126fbbe9d9af43d17602e00dd57a2c1e154e8d5883d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Carcinoma, Squamous Cell - drug therapy</topic><topic>Carcinoma, Squamous Cell - radiotherapy</topic><topic>Carcinoma, Squamous Cell - secondary</topic><topic>Cisplatin - administration & dosage</topic><topic>Combined Modality Therapy</topic><topic>Deglutition Disorders - diagnosis</topic><topic>Deglutition Disorders - etiology</topic><topic>Deglutition Disorders - therapy</topic><topic>dysphagia</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>head and neck neoplasm</topic><topic>Head and Neck Neoplasms - drug therapy</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Head and Neck Neoplasms - radiotherapy</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>radiotherapy</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Conformal - adverse effects</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><topic>toxicity</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koiwai, Keiichiro</creatorcontrib><creatorcontrib>Shikama, Naoto</creatorcontrib><creatorcontrib>Sasaki, Shigeru</creatorcontrib><creatorcontrib>Shinoda, Atsunori</creatorcontrib><creatorcontrib>Kadoya, Masumi</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Japanese journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koiwai, Keiichiro</au><au>Shikama, Naoto</au><au>Sasaki, Shigeru</au><au>Shinoda, Atsunori</au><au>Kadoya, Masumi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Severe Dysphagia after Concurrent Chemoradiotherapy for Head and Neck Cancers</atitle><jtitle>Japanese journal of clinical oncology</jtitle><addtitle>Jpn J Clin Oncol</addtitle><date>2009-07-01</date><risdate>2009</risdate><volume>39</volume><issue>7</issue><spage>413</spage><epage>417</epage><pages>413-417</pages><issn>0368-2811</issn><eissn>1465-3621</eissn><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/m2 (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.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>19383615</pmid><doi>10.1093/jjco/hyp033</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - adverse effects Antineoplastic Combined Chemotherapy Protocols - therapeutic use Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - radiotherapy Carcinoma, Squamous Cell - secondary Cisplatin - administration & dosage Combined Modality Therapy Deglutition Disorders - diagnosis Deglutition Disorders - etiology Deglutition Disorders - therapy dysphagia Female Fluorouracil - administration & dosage head and neck neoplasm Head and Neck Neoplasms - drug therapy Head and Neck Neoplasms - pathology Head and Neck Neoplasms - radiotherapy Humans Male Middle Aged Neoplasm Staging Prognosis radiotherapy Radiotherapy Dosage Radiotherapy, Conformal - adverse effects Retrospective Studies Risk Factors Survival Rate toxicity Treatment Outcome Young Adult |
| title | Risk Factors for Severe Dysphagia after Concurrent Chemoradiotherapy for Head and Neck Cancers |
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