Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume 34, Issue 7, Pages 967-973Publisher
WILEY-BLACKWELL
DOI: 10.1002/hed.21842
Keywords
head and neck cancer; intensity-modulated radiation therapy; chemotherapy; pharyngoesophageal stricture; swallowing function
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Background The purpose of this study was to report the risk of pharyngoesophageal stricture after treatment for head and neck cancer. Methods Human studies on radiation therapy with or without chemotherapy for head and neck cancer published in peer-reviewed journals with assessment of pharyngoesophageal stricture with barium swallow or endoscopy were included. Results A total of 4727 patients from 26 studies treated between 1989 and 2008 were eligible for analysis. The reported overall risk of stricture was 7.2%. The risks of pharyngoesophageal stricture in both conventional and intensity-modulated radiation therapy (IMRT) studies were 5.7% and 16.7%, respectively (p < .001). Use of concurrent (p < .001) and taxane (p = .01) chemotherapy was associated with the IMRT technique. Prospective studies reported a 3.3-fold increased risk of stricture compared with that of retrospective studies (odds ratio: 3.3; 95% confidence interval: 2.34.8; p < .001). Conclusions Pharyngoesophageal stricture after IMRT and chemotherapy treatment for head and neck cancer is not uncommon. Videofluoroscopic swallow study should be performed prospectively to evaluate swallowing function. (c) 2011 Wiley Periodicals, Inc. Head Neck, 2012
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