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Systematic Review of Dose–Volume Correlates for Structures Related to Late Swallowing Disturbances After Radiotherapy for Head and Neck Cancer

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Abstract

Background

We analyzed published dose–volume data of the structures related to late radiotherapy-induced swallowing disturbances in head-and-neck cancer to estimate their sensitivity, specificity, and predictive value and to propose minimal criteria for future studies.

Methods

We performed a systematic literature search to identify dose–volume correlates with late swallowing disturbances. Study design, dose–volume data, toxicity evaluation, and statistical methods were considered in the analysis.

Results

Seven studies were found, among which one prospective study reported exact dose–volume correlates for individual swallowing structures. Four studies identified dose–volume correlates without reporting exact numbers. One study did not find any correlate of dose–volume data of the swallowing structures with late swallowing disturbances. Variations in patient characteristics, study design, methodology, and statistics made any comparison difficult. However, mean dose to the pharyngeus constrictor muscles appeared to be the most demonstrative predictor of late swallowing disturbances, e.g., reducing the mean dose to the pharyngeal constrictor muscles from 61–64 to 52–55 Gy resulted in fewer swallowing disturbances. There were no available data to estimate sensitivity, specificity, or predictive value of the reported dose–volume correlates.

Conclusion

Mean dose to the pharyngeal constrictor muscles appeared to be the most important dosimetric predictor of late swallowing disturbances. Suggested dose–volume correlates require validation in prospective well-designed clinical trials, applying appropriate statistical methods that would account for possible interfering factors.

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Acknowledgments

This work was supported by scientific grants from the Vlaamse Liga Tegen Kanker, the Stichting Tegen Kanker, and the Agentschap voor Innovatie door Wetenschap en Technologie.

Conflict of interest

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    Fréderic Duprez, Indira Madani, Bruno De Potter, Tom Boterberg & Wilfried De Neve

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  1. Fréderic Duprez
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  2. Indira Madani
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Correspondence to Fréderic Duprez.

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Duprez, F., Madani, I., De Potter, B. et al. Systematic Review of Dose–Volume Correlates for Structures Related to Late Swallowing Disturbances After Radiotherapy for Head and Neck Cancer. Dysphagia 28, 337–349 (2013). https://doi.org/10.1007/s00455-013-9452-2

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  • DOI: https://doi.org/10.1007/s00455-013-9452-2

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