Chemo, Radiation Protocol Aimed at Reducing Dysphagia Effective
Chemoradiotherapy/intensity-modulated radiotherapy regimen found safe, effective in oropharyngeal cancer
FRIDAY, April 30 (HealthDay News) -- Chemoradiotherapy with intensity-modulated radiotherapy (IMRT) aimed at reducing dysphagia can provide high locoregional control in patients with oropharyngeal cancer (OPC) while sparing non-involved swallowing structures, according to a study published online April 26 in the Journal of Clinical Oncology.
Felix Y. Feng, M.D., of the University of Michigan in Ann Arbor, and colleagues evaluated the use of chemoradiotherapy using IMRT in 73 patients with stages III to IV OPC. They aimed to spare parts of the swallowing structures not involved by tumor: pharyngeal constrictors, glottic and supraglottic larynx and esophagus, and also major salivary glands and the oral cavity.
At a median follow-up of 36 months, the researchers found that the three-year disease-free survival was 88 percent and the locoregional recurrence-free survival was 96 percent. While all dysphagia measures worsened shortly after therapy, observer-rated and patient-reported scores improved over 12 months, but videofluoroscopy scores did not recover. A year after therapy, observer-rated dysphagia was minimal or nonexistent in all but four patients.
"Chemoradiotherapy with IMRT aiming to reduce dysphagia can be performed safely for OPC and has high locoregional tumor control rates," the authors write. "On average, long-term patient-reported, observer-rated, and objective measures of swallowing were only slightly worse than pretherapy measures, representing potential improvement compared with previous studies."