Late toxicities in locally advanced head and neck squamous cell carcinoma treated with intensity modulated radiation therapy
- Author:
Sandeep MUZUMDER
1
;
Nirmala SRIKANTIA
;
Avinash H. UDAYASHANKAR
;
Prashanth Bhat KAINTHAJE
;
M. G. John SEBASTIAN
;
John Michael RAJ
Author Information
- Publication Type:Original Article
- From:Radiation Oncology Journal 2021;39(3):184-192
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:The study aims to report late toxicities in locally advanced head-and-neck squamous cell carcinoma (LAHNSCC) treated with intensity-modulated radiation therapy (IMRT).
Materials and Methods:A retrospective study was conducted on 103 patients of LAHNSCC treated with IMRT. We analyzed the cumulative incidence of late xerostomia, dysphagia, and aspiration at an interval of 6-month, 1-year, 2-year, and 3-year from the start of IMRT.
Results:At a median follow up of 4.2 years (interquartile range, 3.5 to 6 years), the cumulative incidence of grade ≥2 late xerostomia was 5.5%, dysphagia was 6.9%, and aspiration was 11.1%. Logistic regression showed that Dmean of ≥26 Gy to parotids had higher risk of xerostomia (hazard ratio [HR] = 5.19; 95% confidence interval [CI], 1.90–14.22; p = 0.001). Late dysphagia was associated with Dmean of ≥45 Gy to pharyngeal constrictors (PC) (HR = 7; 95% CI, 1.84–26.61; p =0.004), ≥55 Gy to larynx (HR = 3.25; 95% CI, 1.15–9.11; p = 0.025), and adjuvant RT (HR = 5.26; 95% CI, 1.85–14.87; p = 0.002). Aspiration was associated with Dmean of ≥45 Gy to larynx (HR = 6.5; 95% CI, 1.93–21.88; p = 0.003), Dmean of ≥55 Gy to PC (HR = 3.54; 95% CI, 1.25–9.98; p = 0.017), and patients having late dysphagia (HR = 4.37; 95% CI, 1.55–12.31; p = 0.005).
Conclusions:IMRT is a feasible radiation delivery technique in LAHNSCC with a decreased late toxicity profile.
