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Open Access 19-05-2022 | Radiotherapy | Original Article

Patient-Reported Outcomes After Swallowing (SWOARs)-Sparing IMRT in Head and Neck Cancers: Primary Results from a Prospective Study Endorsed by the Head and Neck Study Group (HNSG) of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Authors: Stefano Ursino, Elisa Calistri, Francesca De Felice, Pierluigi Bonomo, Isacco Desideri, Pierfrancesco Franco, Francesca Arcadipane, Caterina Colosimo, Rosario Mazzola, Marta Maddalo, Alessandra Gonnelli, Giulia Malfatti, Riccardo Morganti, Daniela Musio, Fabiola Paiar

Published in: Dysphagia | Issue 1/2023

Abstract

Objectives

To prospectively investigate changes in M.D. Anderson Dysphagia Inventory (MDADI) scores in patients affected by naso- and oropharynx cancer after definitive radiochemotherapy (ChemoRT) using swallowing organs at risk (SWOARs)-sparing IMRT.

Methods

MDADI questionnaires were collected at baseline and at 6 and 12 months after treatment. MDADI scores were categorized as follows: ≥ 80 “optimal,” 80–60 “adequate,” < 60 “poor” deglutition-related quality of life (QoL) group, and dichotomized as “optimal” vs “adequate/poor” for the analysis. A mean MDADI composite (MDADI-C) change of 10 points was considered as minimal clinically important difference (MCID).

Results

Sixty-three patients were enrolled of which 47 were considered for the analysis. At baseline, 26 (55%) were “optimal” and 21 (45%) were “adequate/poor.” The mean baseline MDADI-C score was 93.6 dropping to 81 at 6 months (p = 0.013) and slightly rising to 85.5 at 12 months (p = 0.321) for the “optimal” group. Indeed, the mean baseline MDADI-C score was 64.3 rising to 77.5 at 6 months (p = 0.006) and stabilizing at 76 at 12 months (p = 0.999) for the “adequate/poor” group. A statistically significant but not clinically relevant worsening of the MDADI-C score was reported for the “optimal” group, whereas both a statistically significant and clinically meaningful improvement of the MDADI-C score were reported for the “adequate/poor” group from before to post-treatment.

Conclusion

Our results suggest a doubly clinical benefit of dose optimization to SWOARs to minimize the RT sequalae in patients with a baseline “optimal” deglutition-related QoL and to recover from cancer dysphagia in those with a baseline “adequate/poor” deglutition-related QoL.

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Title: Patient-Reported Outcomes After Swallowing (SWOARs)-Sparing IMRT in Head and Neck Cancers: Primary Results from a Prospective Study Endorsed by the Head and Neck Study Group (HNSG) of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)
Authors: Stefano Ursino
Elisa Calistri
Francesca De Felice
Pierluigi Bonomo
Isacco Desideri
Pierfrancesco Franco
Francesca Arcadipane
Caterina Colosimo
Rosario Mazzola
Marta Maddalo
Alessandra Gonnelli
Giulia Malfatti
Riccardo Morganti
Daniela Musio
Fabiola Paiar
Publication date: 19-05-2022
Publisher: Springer US
Keywords: Radiotherapy
Dysphagia
Dysphagia
Dysphagia
Published in: Dysphagia / Issue 1/2023
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI: https://doi.org/10.1007/s00455-022-10434-4

At a glance: The STEP trials

Springer Medicine

Patient-Reported Outcomes After Swallowing (SWOARs)-Sparing IMRT in Head and Neck Cancers: Primary Results from a Prospective Study Endorsed by the Head and Neck Study Group (HNSG) of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Abstract

Objectives

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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