The Relationships Between Radiation Dosage and Long-term Swallowing Kinematics and Timing in Nasopharyngeal Carcinoma Survivors

Abstract

This study aimed to investigate the relationship between intensity-modulated radiation therapy (IMRT) dosimetry and swallowing kinematic and timing measures. Thirteen kinematic and timing measures of swallowing from videofluoroscopic analysis were used as outcome measures to reflect swallowing function. IMRT dosimetry was accessed for thirteen swallowing-related structures. A cohort of 44 nasopharyngeal carcinoma (NPC) survivors at least 3 years post-IMRT were recruited. The cohort had a mean age of 53.2 ± 11.9 years, 77.3% of whom were male. There was an average of 68.24 ± 14.15 months since end of IMRT; 41 (93.2%) had undergone concurrent chemotherapy. For displacement measures, female sex and higher doses to the cricopharyngeus, glottic larynx, and base of tongue were associated with reduced hyolaryngeal excursion and pharyngeal constriction, and more residue. For timing measures, higher dose to the genioglossus was associated with reduced processing time at all stages of the swallow. The inferior pharyngeal constrictor emerged with a distinctly different pattern of association with mean radiation dosage compared to other structures. Greater changes to swallowing kinematics and timing were observed for pudding thick consistency than thin liquid. Increasing radiation dosage to swallowing-related structures is associated with reduced swallowing kinematics. However, not all structures are affected the same way, therefore organ sparing during treatment planning for IMRT needs to consider function rather than focusing on select muscles. Dose-response relationships should be investigated with a comprehensive set of swallowing structures to capture the holistic process of swallowing.

Effects of Swallowing Rehabilitation Training with a Balloon Dilation Therapy on the Deglutition Function and Quality of Life of Patients with Dysphagia after Radiotherapy for Nasopharyngeal Carcinoma

“…Balloon dilation, the most common clinical treatment for dysphagia currently [ 19 ], mainly consists of disposable balloon catheter dilation and multiple balloon catheter dilation. The latter was chosen in this study, that is, a procedure in which a water-fillable balloon with catheters of different diameters is inserted from top to bottom in the patients' cricopharyngeal muscle, whose function is restored by the gradual expansion of the balloon through its changed diameter due to the increasing dose of water injected [ 20 ]. Balloon dilatation has an ideal basis for promotion as a result of the ease of operation and low cost, whose therapeutic effects, however, usually takes long-term, repeated procedures to achieve.…”

Effects of Self-Care plus Forecasting Nursing on the Treatment Outcomes and Emotions in Patients with Nasopharyngeal Carcinoma after Radiotherapy

“…However, clinical studies have shown that radiotherapy can cause adverse reactions to varying degrees. According to relevant research, 96.3% of nasopharyngeal carcinoma patients have xerostomia after radiotherapy, 71.8% have anorexia, 71.2% have swallowing difficulty, and 21.4% have trismus [ 7 ]. These late effects usually last for several weeks or months, and in severe cases for the whole life of the patients, impairing their quality of life and emotions [ 8 ].…”