• Klaudia U Hunter, Oliver E Lee, Teresa H Lyden, Marc J Haxer, Felix Y Feng, Mathew Schipper, Francis Worden, Mark E Prince, Scott A McLean, Gregory T Wolf, Carol R Bradford, Douglas B Chepeha, and Avraham Eisbruch.
• Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
• Head Neck. 2014 Jan 1; 36 (1): 120-5.

BackgroundThe purpose of this study was to assess aspiration pneumonia (AsPn) rates and predictors after chemo-irradiation for head and neck cancer.MethodsThe was a prospective study of 72 patients with stage III to IV oropharyngeal cancer treated definitively with intensity-modulated radiotherapy (IMRT) concurrent with weekly carboplatin and paclitaxel. AsPn was recorded prospectively and dysphagia was evaluated longitudinally through 2 years posttherapy by observer-rated (Common Toxicity Criteria version [CTCAE]) scores, patient-reported scores, and videofluoroscopy.ResultsSixteen patients (20%) developed AsPn. Predictive factors included T classification (p = .01), aspiration detected on videofluoroscopy (videofluoroscopy-asp; p = .0007), and patient-reported dysphagia (p = .02-.0003), but not observer-rated dysphagia (p = .4). Combining T classification, patient reported dysphagia, and videofluoroscopy-asp, provided the best predictive model.ConclusionAsPn continues to be an under-reported consequence of chemo-irradiation for head and neck cancer. These data support using patient-reported dysphagia to identify high-risk patients requiring videofluoroscopy evaluation for preventive measures. Reducing videofluoroscopy-asp rates, by reducing swallowing structures radiation doses and by trials reducing treatment intensity in patients predicted to do well, are likely to reduce AsPn rates.Copyright © 2013 Wiley Periodicals, Inc.

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