A comparison of swallowing dysfunction after three-dimensional conformal and intensity-modulated radiotherapy

PurposeDysphagia is one of the most important treatment-related side effects in head and neck cancer (HNC), as it can lead to severe life-threating complications such as aspiration pneumonia and malnutrition. Intensity-modulated radiotherapy (IMRT) could reduce swallowing dysfunction by producing a...

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Hauptverfasser: Ursino, Stefano (VerfasserIn) , Lohr, Frank (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2017
In: Strahlentherapie und Onkologie
Year: 2017, Jahrgang: 193, Heft: 11, Pages: 877-889
ISSN:1439-099X
DOI:10.1007/s00066-017-1160-7
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1007/s00066-017-1160-7
Verlag, Volltext: https://doi.org/10.1007/s00066-017-1160-7
Volltext
Verfasserangaben:Stefano Ursino, Elisa D’Angelo, Rosario Mazzola, Anna Merlotti, Riccardo Morganti, Agostino Cristaudo, Fabiola Paiar, Daniela Musio, Daniela Alterio, Almalina Bacigalupo, Elvio Grazioso Russi, Frank Lohr

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520 |a PurposeDysphagia is one of the most important treatment-related side effects in head and neck cancer (HNC), as it can lead to severe life-threating complications such as aspiration pneumonia and malnutrition. Intensity-modulated radiotherapy (IMRT) could reduce swallowing dysfunction by producing a concave dose distribution and reducing doses to the swallowing-related organs at risk (SWOARs). The aim of this study was to review the current literature in order to compare swallowing outcomes between IMRT and three-dimensional conformal radiotherapy (3DCRT).MethodsA search was conducted in the PubMed and Embase databases to identify studies on swallowing outcomes, both clinically and/or instrumentally assessed, after 3DCRT and IMRT. Dysphagia-specific quality of life and objective instrumental data are summarized and discussed.ResultsA total of 262 papers were retrieved from the searched databases. An additional 23 papers were retrieved by hand-searching the reference lists. Ultimately, 22 papers were identified which discussed swallowing outcomes after 3DCRT and IMRT for HNC. No outcomes from randomized trials were identified.ConclusionDespite several methodological limitations, reports from the current literature seem to suggest better swallowing outcomes with IMRT compared to 3DCRT. Further improvements are likely to result from the increased use of IMRT plans optimized for SWOAR sparing. 
650 4 |a aspiration 
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650 4 |a Organs at risk 
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