Dose to the Larynx Predicts for Swallowing Complications Following IMRT and Chemotherapy
Carolyn Vachani, RN, MSN, AOCN
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 5, 2007
The combination of chemotherapy and radiation therapy has improved survival for people with head and neck cancers, but this has led to an increase in toxicity. Two concerning side effect are aspiration (breathing food or drink into the lungs, which can lead to pneumonia) and the development of strictures (narrowing of the esophagus or food pipe, which can make eating difficult). These can lead to the need for a feeding tube to prevent pneumonias and maintain weight. This study looked at swallowing function after chemotherapy and radiation therapy.
The study included 96 patients with a variety of head and neck cancers, treated with IMRT and chemotherapy. All patients had their swallowing function evaluated after treatment. 31 patients had aspiration and 36 patients developed stricture. There was no association seen between chemotherapy or area of disease and the complications. Prior tobacco use, however, was significantly associated with these toxicities.
Researchers discovered that limiting the radiation dose to the larynx (voice box) did decrease the risk. IMRT allows the physician better control over the dose of radiation to certain areas, and may improve the risk of these toxicities by decreasing dose to the larynx.
Partially funded by an unrestricted educational grant from Bristol-Myers Squibb.