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Predictors of Patient-Reported Dysphagia Following IMRT Plus Chemotherapy in Oropharyngeal Cancer
- Publication Year :
- 2018
-
Abstract
- The aim of this cross-sectional study is to evaluate the factors associated with patient-reported dysphagia in patients affected by locally advanced oropharyngeal cancer (OPC) treated with definitive intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy (CHT), with or without induction CHT. We evaluated 148 OPC patients treated with IMRT and concurrent CHT, without evidence of disease and who had completed their treatment since at least 6 months. At their planned follow-up visit, patients underwent clinical evaluation and completed the M.D. Anderson dysphagia inventory (MDADI) questionnaire. The association between questionnaire composite score (MDADI-CS) and different patients' and tumor's characteristics and treatments (covariates) was investigated by univariable and multivariable analyses, the latter including only covariates significant at univariable analysis. With a median time from treatment end of 30 months [range 6-74 months, interquartile range (IQR) 16-50 months], the median (IQR) MDADI-CS was 72 (63-84). The majority of patients (82.4%) had a MDADI-CS ≥ 60. At multivariable analysis, female gender, human papilloma virus (HPV)-negative status, and moderate and severe clinician-rated xerostomia were significantly associated with lower MDADI-CS. Patient-perceived dysphagia was satisfactory or acceptable in the majority of patients. HPV status and xerostomia were confirmed as important predictive factors for swallowing dysfunction after radiochemotherapy. Data regarding female gender are new and deserve further investigation.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
030507 speech-language pathology & audiology
03 medical and health sciences
Speech and Hearing
Sex Factors
0302 clinical medicine
human papilloma virus
long-term dysphagia
MDADI score
oropharyngeal carcinoma
xerostomia
Swallowing
Risk Factors
Interquartile range
Surveys and Questionnaires
Internal medicine
otorhinolaryngologic diseases
medicine
Humans
Patient Reported Outcome Measures
Risk factor
Radiation Injuries
Aged
business.industry
Gastroenterology
Induction chemotherapy
Chemoradiotherapy
Middle Aged
Dysphagia
Radiation therapy
Oropharyngeal Neoplasms
Cross-Sectional Studies
Otorhinolaryngology
Multivariate Analysis
Female
Patient-reported outcome
Radiotherapy, Intensity-Modulated
medicine.symptom
Deglutition Disorders
0305 other medical science
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....faaee48369d1175f1f722b91697c49b3