Radiotherapy dose-volume parameters predict videofluoroscopy-detected dysphagia per DIGEST after IMRT for oropharyngeal cancer: Results of a prospective registry.

摘要: Abstract Purpose Our primary aim was to prospectively validate retrospective dose–response models of chronic radiation-associated dysphagia (RAD) after intensity modulated radiotherapy (IMRT) for oropharyngeal cancer (OPC). The secondary a grade ≥2 cut-point the published videofluoroscopic severity (Dynamic Imaging Grade Swallowing Toxicity, DIGEST) as radiation dose-dependent. Material and methods Ninety-seven patients enrolled on an IRB-approved prospective registry protocol with stage I–IV OPC underwent pre- 3–6 month post-RT videofluoroscopy. Dose–volume histograms (DVH) swallowing regions interest (ROI) were calculated. Dysphagia graded per DIGEST criteria (dichotomized moderate/severe RAD). Recursive partitioning analysis (RPA) Bayesian Information Criteria (BIC) used identify dose–volume effects associated RAD. Results 31% developed RAD (i.e. ≥2) at 3–6 months RT. RPA found DVH-derived dosimetric parameters geniohyoid/mylohyoid (GHM), superior pharyngeal constrictor (SPC), supraglottic region V61 ≥ 18.57% GHM demonstrated optimal model performance prediction ≥2. Conclusion findings from this longitudinal prior observations that dose submental musculature predicts increased burden IMRT. Findings also support dichotomization dose-dependent split use endpoint in trials or predictive videofluoroscopy results.