• Keiichiro Koiwai, Naoto Shikama, Shigeru Sasaki, Atsunori Shinoda, and Masumi Kadoya.
• Department of Radiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan. kkoiwai@shinshu-u.ac.jp
• Jpn. J. Clin. Oncol. 2009 Jul 1; 39 (7): 413-7.

ObjectiveThe aim of this study was to investigate the risk factors for dysphagia induced by chemoradiotherapy for head and neck cancers.MethodsForty-seven patients with head and neck cancers who underwent definitive chemoradiotherapy from December 1998 to March 2006 were reviewed retrospectively. Median age was 63 years (range, 16-81). The locations of the primary lesion were as follows: larynx in 18 patients, oropharynx in 11, nasopharynx in 7, hypopharynx in 7 and others in 4. Clinical stages were as follows: Stage II in 20 and Stages III-IV in 27. Almost all patients underwent platinum-based concomitant chemoradiotherapy. The median cumulative dose of cisplatin was 100 mg/m(2) (range, 80-300) and median radiation dose was 70 Gy (range, 50-70).ResultsSevere dysphagia (Grade 3-4) was observed in 22 patients (47%) as an acute toxic event. One patient required tube feeding even at 12-month follow-up. In univariate analysis, clinical stage (III-IV) (P = 0.017), primary site (oro-hypopharynx) (P = 0.041) and radiation portal size (>11 cm) (P < 0.001) were found to be associated with severe dysphagia. In multivariate analysis, only radiation portal size was found to have a significant relationship with severe dysphagia (P = 0.048).ConclusionsLarger radiation portal field was associated with severe dysphagia induced by chemoradiotherapy.

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