Predictors of Patient-Reported Dysphagia Following IMRT Plus Chemotherapy in Oropharyngeal Cancer.
Aged
Chemoradiotherapy
/ adverse effects
Cross-Sectional Studies
Deglutition Disorders
/ etiology
Female
Humans
Male
Middle Aged
Multivariate Analysis
Oropharyngeal Neoplasms
/ therapy
Patient Reported Outcome Measures
Radiation Injuries
/ etiology
Radiotherapy, Intensity-Modulated
/ adverse effects
Risk Factors
Sex Factors
Surveys and Questionnaires
Human papilloma virus
Long-term dysphagia
MDADI score
Oropharyngeal carcinoma
Xerostomia
Journal
Dysphagia
ISSN: 1432-0460
Titre abrégé: Dysphagia
Pays: United States
ID NLM: 8610856
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
11
09
2017
accepted:
29
05
2018
pubmed:
28
6
2018
medline:
23
8
2019
entrez:
28
6
2018
Statut:
ppublish
Résumé
The aim of this cross-sectional study is to evaluate the factors associated with patient-reported dysphagia in patients affected by locally advanced oropharyngeal cancer (OPC) treated with definitive intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy (CHT), with or without induction CHT. We evaluated 148 OPC patients treated with IMRT and concurrent CHT, without evidence of disease and who had completed their treatment since at least 6 months. At their planned follow-up visit, patients underwent clinical evaluation and completed the M.D. Anderson dysphagia inventory (MDADI) questionnaire. The association between questionnaire composite score (MDADI-CS) and different patients' and tumor's characteristics and treatments (covariates) was investigated by univariable and multivariable analyses, the latter including only covariates significant at univariable analysis. With a median time from treatment end of 30 months [range 6-74 months, interquartile range (IQR) 16-50 months], the median (IQR) MDADI-CS was 72 (63-84). The majority of patients (82.4%) had a MDADI-CS ≥ 60. At multivariable analysis, female gender, human papilloma virus (HPV)-negative status, and moderate and severe clinician-rated xerostomia were significantly associated with lower MDADI-CS. Patient-perceived dysphagia was satisfactory or acceptable in the majority of patients. HPV status and xerostomia were confirmed as important predictive factors for swallowing dysfunction after radiochemotherapy. Data regarding female gender are new and deserve further investigation.
Identifiants
pubmed: 29948260
doi: 10.1007/s00455-018-9913-8
pii: 10.1007/s00455-018-9913-8
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Pagination
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