Abstract | BACKGROUND AND PURPOSE: METHODS AND MATERIALS: A retrospective study was performed on 141 consecutive patients with LAHNC (squamous cell) treated with definitive chemoIMRT with weekly concurrent carboplatin and paclitaxel. Late dysphagia was assessed by length of PEG requirement. Analysis of IMRT dose was retrospectively performed for critical swallowing structures. RESULTS: Approximately 62% of patients required PEG, the majority placed during treatment. Mean and median time for PEG was 7.7 and 4.4 months respectively (range 1.4-43.8). Only IMRT dose to the inferior constrictor was significantly associated with length of PEG. Mean dose (of individual mean doses) was 47 Gy for prolonged PEG use versus 41 Gy for PEG ⩽ 12 months. V40 to the inferior constrictor also correlated with PEG >12 months (p = 0.02) with a mean V40 of 48% versus 41% for PEG ⩽ 12 months. CONCLUSIONS: IMRT dose to the inferior constrictor correlated with persistent dysphagia requiring prolonged PEG use. Maintaining mean inferior constrictor dose to ⩽ 41 Gy and V40 to ⩽ 41% may help minimize gastrostomy tube dependence.
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Authors | Gregory Vlacich, Daniel E Spratt, Roberto Diaz, John G Phillips, Jostin Crass, Chung-I Li, Yu Shyr, Anthony J Cmelak |
Journal | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
(Radiother Oncol)
Vol. 110
Issue 3
Pg. 435-40
(Mar 2014)
ISSN: 1879-0887 [Electronic] Ireland |
PMID | 24440043
(Publication Type: Journal Article)
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Copyright | Copyright © 2014. Published by Elsevier Ireland Ltd. |
Topics |
- Adult
- Aged
- Aged, 80 and over
- Chemoradiotherapy
- Female
- Gastrostomy
- Head and Neck Neoplasms
(therapy)
- Humans
- Male
- Middle Aged
- Pharynx
(radiation effects)
- Radiotherapy Dosage
- Radiotherapy, Intensity-Modulated
(methods)
- Retrospective Studies
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