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Swallowing dysfunction is a common sequelae after chemoradiation for oropharynx carcinoma
Kathryn M Greven1, Douglas R White, J Dale Browne
1Departments of Radiation Oncology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. kgreven@wfubmc.edu
American Journal of Clinical Oncology
|June 6, 2008
Summary
Adding concurrent chemotherapy to radiotherapy for advanced oropharynx cancer significantly improves survival and local control. However, it also increases the risk of swallowing dysfunction.
Area of Science:
- Oncology
- Radiation Oncology
- Head and Neck Cancer
Background:
- Retrospective review of advanced oropharynx cancer patients.
- Focus on stage III/IV disease treated with definitive radiotherapy.
Purpose of the Study:
- To evaluate the efficacy and toxicity of concurrent chemotherapy with radiotherapy for advanced oropharynx cancer.
- To identify independent predictors of treatment outcomes.
Main Methods:
- Review of 67 patients with stage III/IV oropharynx cancer treated between 1990-2004.
- Comparison of outcomes between radiotherapy alone and radiotherapy with concurrent chemotherapy.
- Follow-up ranged from 6 to 91 months (median 32 months).
Main Results:
- Concurrent chemotherapy significantly improved control above clavicles, primary control, disease-free survival, and overall survival.
- No difference in distant control at 3 years was observed.
- Concurrent chemoradiation led to a higher incidence of severe dysphagia (18% vs 0%).
Conclusions:
- Concurrent chemotherapy is associated with decreased recurrence rates in the primary site and above the clavicles.
- The main trade-off for improved oncologic outcomes is an increased incidence of swallowing dysfunction.
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