Sparing Swallowing-Related Structures Reduces Post-Radiotherapy Dysphagia in Oropharyngeal Cancer

Abstract

Objective: To identify swallowing-related structures (SRSs) predicting post-radiotherapy dysphagia in oropharyngeal carcinoma patients. Material and methods: Between September 2020 and October 2022, oropharyngeal cancer patients who had completed radiotherapy at least one year before without recurrence or residuals were selected. They underwent flexible endoscopic evaluation of swallowing (FEES) assessments and dysphagia grading. The mean radiation doses delivered to their SRSs were recalculated. The correlation between radiation doses to each SRS and FEES scores was analysed. Results: Twenty-nine participants, aged 51–73 years, were enrolled. Six patients had received two-dimensional radiotherapy, eight had undergone three-dimensional conformal radiotherapy, and fifteen had received intensity-modulated radiation therapy. Radiation doses to the inferior pharyngeal constrictor, cricopharyngeus and glottic larynx significantly predicted dysphagia for both semisolids (p = 0.023, 0.030 and 0.001) and liquid diets (p = 0.021, 0.013 and 0.002). The esophageal inlet significantly predicted swallowing outcomes for only the liquid diet (p = 0.007). Conclusions: This study supports that SRS-sparing during radiotherapy for oropharyngeal cancers improves swallowing outcomes.