Impact of selective neck dissection on chronic dysphagia after chemo‐intensity‐modulated radiotherapy for oropharyngeal carcinoma. Issue 6 (4th September 2015)

• Record Type: Journal Article
• Authors: Hutcheson, Katherine A.; Abualsamh, Amal R.; Sosa, Alejandro; Weber, Randal S.; Beadle, Beth M.; Sturgis, Erich M.; Lewin, Jan S.
• Is Part Of: Head & neck. Volume 38:Issue 6(2016)
• Page Start: 886
• Page End: 893
• Publication Date: 2015-09-04
• Subjects: dysphagia -- neck dissection -- oropharyngeal cancer -- chemoradiation; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.24195
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Conflicting results are reported regarding the impact of neck dissection on radiation‐associated dysphagia. The purpose of this study was to reexamine this question specific to oropharyngeal intensity‐modulated radiotherapy (IMRT). Methods: Three hundred forty‐nine patients with oropharyngeal cancer treated with bilateral IMRT with systemic therapy (induction and/or concurrent) were reviewed. Chronic dysphagia was defined by aspiration, stricture, pneumonia, and/or gastrostomy dependence ≥12 months post‐IMRT. Results: Selective neck dissection was performed after IMRT in 75 patients (21%). Overall, 41 patients (12%) developed chronic dysphagia. Neck dissection did not increase the rate of chronic dysphagia (9% neck dissection; 12% no neck dissection; p = .464) or gastrostomy duration ( p = .482). On multivariate analysis, age (odds ratio [OR] per 5‐year = 1.25; 95% confidence interval [CI] = 1.04–1.51), baseline abnormal diet (OR = 2.78; 95% CI = 1.31–5.88), and IMRT dose (OR per 5‐Gy = 5.11; 95% CI = 1.77–14.81) significantly predicted dysphagia. Conclusion: In the setting of selective neck dissection for residual adenopathy after IMRT, neck dissection did not impact dysphagia. © 2015 Wiley Periodicals, Inc. Head Neck 38: 886–893, 2016