ArticleInternational journal of radiation oncology, biology, physics2023
Dysphagia at 1 Year is Associated With Mean Dose to the Inferior Section of the Brain Stem.
Article in International journal of radiation oncology, biology, physics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Article
- Article
- Multidimensional analysis of postoperative nursing challenges in oral cancer surgery: a retrospective study of 245 patients and proposal of the PROTECT mode.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Deep learning NTCP model for late dysphagia after radiotherapy for head and neck cancer patients based on 3D dose, CT and segmentations.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2025Article
- Voxel-Based Dose-Toxicity Modeling for Predicting Post-Radiotherapy Toxicity: A Critical Perspective.Journal of clinical medicine · 2025Article
- Individualised dose mapping uncertainty estimation in the reirradiation setting.Physics and imaging in radiation oncology · 2025Article
- Geometric, dosimetric and psychometric evaluation of three commercial AI software solutions for OAR auto-segmentation in head and neck radiotherapy.Scientific reports · 2025Article
- Dose-response mapping of bladder and rectum in prostate cancer patients undergoing radiotherapy with and without baseline toxicity correction.Physics and imaging in radiation oncology · 2025Article
- Optimising inter-patient image registration for image-based data mining in breast radiotherapy.Physics and imaging in radiation oncology · 2024Article
- Validation of quantitative magnetic resonance imaging techniques in head and neck healthy structures involved in the salivary and swallowing function: Accuracy and repeatability.Physics and imaging in radiation oncology · 2024Article
- The role of the soft palate dose regarding normal tissue toxicities in older adults with head and neck cancer undergoing definitive radiotherapy.Radiation oncology (London, England) · 2024Article
- Review and recommendations on deformable image registration uncertainties for radiotherapy applications.Physics in medicine and biology · 2023Review
- Predictive Factors for Chemoradiation-Induced Oral Mucositis and Dysphagia in Head and Neck Cancer: A Scoping Review.Cancers · 2023Article
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Authors and funding
7 authors.
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Abstract
purposeDysphagia is a common toxicity after head and neck (HN) radiation therapy that negatively affects quality of life. We explored the relationship between radiation therapy dose to normal HN structures and dysphagia 1 year after treatment using image-based datamining (IBDM), a voxel-based analysis technique. METHODS AND MATERIALS: We used data from 104 patients with oropharyngeal cancer treated with definitive (chemo)radiation therapy. Swallow function was assessed pretreatment and 1 year posttreatment using 3 validated measures: MD Anderson Dysphagia Inventory (MDADI), performance status scale for normalcy of diet (PSS-HN), and water swallowing test (WST). For IBDM, we spatially normalized all patients' planning dose matrices to 3 reference anatomies. Regions where the dose was associated with dysphagia measures at 1 year were found by performing voxel-wise statistics and permutation testing. Clinical factors, treatment variables, and pretreatment measures were used in multivariable analysis to predict each dysphagia measure at 1 year. Clinical baseline models were found using backward stepwise selection. Improvement in model discrimination after adding the mean dose to the identified region was quantified using the Akaike information criterion. We also compared the prediction performance of the identified region with a well-established association: mean doses to the pharyngeal constrictor muscles.
resultsIBDM revealed highly significant associations between dose to distinct regions and the 3 outcomes. These regions overlapped around the inferior section of the brain stem. All clinical models were significantly improved by including mean dose to the overlap region (P ≤ .006). Including pharyngeal dosimetry significantly improved WST (P = .04) but not PSS-HN or MDADI (P ≥ .06).
conclusionsIn this hypothesis-generating study, we found that mean dose to the inferior section of the brain stem is strongly associated with dysphagia 1 year posttreatment. The identified region includes the swallowing centers in the medulla oblongata, providing a possible mechanistic explanation. Further work including validation in an independent cohort is required.
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