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Impact of selective neck dissection on chronic dysphagia after chemo-intensity-modulated radiotherapy for oropharyngeal carcinoma

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Impact of selective neck dissection on chronic dysphagia after chemo-intensity-modulated radiotherapy for oropharyngeal carcinoma HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK Hutcheson, K. A., Abualsamh, A. R., Sosa, A., Weber, R. S., Beadle, B. M., Sturgis, E. M., Lewin, J. S. 2016; 38 (6): 886-893

Abstract

Conflicting results are reported regarding the impact of neck dissection on radiation-associated dysphagia. The purpose of this study was to reexamine this question specific to oropharyngeal intensity-modulated radiotherapy (IMRT).Three hundred forty-nine patients with oropharyngeal cancer treated with bilateral IMRT with systemic therapy (induction and/or concurrent) were reviewed. Chronic dysphagia was defined by aspiration, stricture, pneumonia, and/or gastrostomy dependence =12 months post-IMRT.Selective neck dissection was performed after IMRT in 75 patients (21%). Overall, 41 patients (12%) developed chronic dysphagia. Neck dissection did not increase the rate of chronic dysphagia (9% neck dissection; 12% no neck dissection; p?=?.464) or gastrostomy duration (p?=?.482). On multivariate analysis, age (odds ratio [OR] per 5-year?=?1.25; 95% confidence interval [CI]?=?1.04-1.51), baseline abnormal diet (OR?=?2.78; 95% CI?=?1.31-5.88), and IMRT dose (OR per 5-Gy?=?5.11; 95% CI?=?1.77-14.81) significantly predicted dysphagia.In the setting of selective neck dissection for residual adenopathy after IMRT, neck dissection did not impact dysphagia. © 2015 Wiley Periodicals, Inc. Head Neck 38: 886-893, 2016.

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