Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium.
Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium.
Head Neck. 2019 Oct;41(10):3594-3603. doi: 10.1002/hed.25880. Epub 2019 Jul 22.
Acute and late toxicity after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC) impacts on patient quality of life; yet, very late toxicity data remain scarce. This study assessed dysphagia, xerostomia, and neck fibrosis 3-8 years after IMRT.
A retrospective analysis using generalized estimated equations was performed on 60 patients with HNC treated with fractionated IMRT between 2000 and 2015 who had a follow-up ≥8 years. Toxicity was scored using LENT-SOMA scales.
A trend towards a nonlinear global time effect (P = .05) was noted for dysphagia with a decrease during the 5 years post-treatment and an increase thereafter. A significant decrease in xerostomia (P = .001) and an increase in neck fibrosis (P = .04) was observed until 8 years.
Dysphagia, xerostomia, and neck fibrosis do not appear stable over time and remain highly prevalent in the very late follow-up. Our findings support the need for prospective trials investigating very late toxicity in patients with HNC.
头颈部癌症（HNC）调强放疗（IMRT）后的急性和晚期毒性会影响患者的生活质量；然而，非常晚期的毒性数据仍然很少。本研究评估了 IMRT 治疗后 3-8 年的吞咽困难、口干和颈部纤维化。
对 2000 年至 2015 年间接受分割 IMRT 治疗的 60 例 HNC 患者进行了回顾性分析，这些患者的随访时间≥8 年。采用 LENT-SOMA 量表对毒性进行评分。
吞咽困难的整体时间效应呈非线性趋势（P =.05），治疗后 5 年内下降，此后上升。观察到口干（P =.001）显著下降和颈部纤维化（P =.04）增加，直到 8 年。
吞咽困难、口干和颈部纤维化随时间推移似乎并不稳定，在非常晚期随访中仍高度普遍。我们的研究结果支持需要进行前瞻性试验，以研究 HNC 患者的非常晚期毒性。
