Radiotherapy, University Hospital "Maggiore della Carità", via Solaroli, 17, 28100, Novara, Italy.
Strahlenther Onkol. 2013 Mar;189(3):230-6. doi: 10.1007/s00066-012-0288-8. Epub 2013 Jan 16.
Dysphagia is a complication of head and neck cancer patients undergoing radiotherapy (RT). We analysed frequency and severity of swallowing dysfunction and correlated these findings with dose-volume histograms (DVHs) of the pharyngeal constrictor muscles.
A total of 50 patients treated by radical RT were enrolled. DVHs of constrictor muscles were correlated with acute and late dysphagia and with the items of three quality of life questionnaires.
Mean dose to superior and middle constrictor muscles (SCM, MCM), partial volume of SCM and MCM receiving a dose ≥ 50 Gy dose to the whole constrictor muscles ≥ 60 Gy and tumour location were associated to late dysphagia at univariate analysis. Mean dose to the MCM was the only statistically significant predictor of late dysphagia at the multivariable analysis.
The study shows a significant relationship between long-term dysphagia and mean doses to SCM, MCM, whole constrictor muscles, and oropharyngeal tumour. This finding suggests a potential advantage in reducing the RT dose to swallowing structures to avoid severe dysphagia.
吞咽困难是头颈部癌症患者接受放射治疗（RT）的一种并发症。我们分析了吞咽功能障碍的频率和严重程度，并将这些发现与咽缩肌的剂量-体积直方图（DVH）相关联。
共纳入 50 例接受根治性 RT 的患者。对缩肌的 DVH 与急性和晚期吞咽困难以及三个生活质量问卷的项目进行了相关性分析。
在单因素分析中，上、中缩肌（SCM、MCM）的平均剂量、SCM 和 MCM 的部分体积接受≥50 Gy 剂量的全缩肌≥60 Gy 剂量和肿瘤位置与晚期吞咽困难相关。多变量分析中，MCM 的平均剂量是晚期吞咽困难的唯一统计学显著预测因子。
该研究表明长期吞咽困难与 SCM、MCM、全缩肌和口咽肿瘤的平均剂量之间存在显著关系。这一发现表明，降低吞咽结构的 RT 剂量以避免严重吞咽困难可能具有潜在优势。
