Akademik Veri Yönetim Sistemi
Masters of Head and Neck Surgery IFHNOS 2025, İstanbul, Türkiye, 13 - 15 Kasım 2025, (Yayınlanmadı)
Objective
Dysphagia is a common chemoradiotherapy (cRT) related toxicity in nasopharyngeal carcinoma(NCa), causing nutritional impairment. Herein we aimed to evaluate the association between RT doseto the PCM and the development of dysphagia in patients undergoing RT for NCa.
Material and method
Fifty-seven patients diagnosed with NCa and treated with cRT between 2012 and 2024 evaluatedretrospectively. All RT plans were generated using a single planning system. The PCM weresubdivided into 3 substructures as—superior (S), middle (M), inferior (I) and delineatedretrospectively (Figure-1). Dose–volume histogram (DVH) metrics for each substructure wereextracted. Dysphagia was evaluated weekly during treatment and graded according to RTOG criteria.Associations between DVH metrics and dysphagia were analyzed using Spearman correlation, ROCanalysis, and logistic regression. Statistical analyses were performed with SPSS v23, and p < 0.05was considered significant.
Results
Patient and treatment details are summarized in Table 1. Median age was 54 years (18–87), and 80%had stage III–IV disease. The prescribed primary PTV median dose was 70 Gy (66–70 Gy) in median33 (30–35) fractions, mostly with the SIB technique (68%). Dysphagia developed in all patients,beginning in week 2 and peaking at week 5, when 100% had ≥grade 1 and 66% had grade 2–3toxicity; no grade 4 toxicity observed. Esophageal Dmax (p = 0.02, r=0.5) and S-/ M-PCM D80 (p =0.03 and 0.008, r=0.5 both) and D70 (p = 0.02 and 0.01, r=0.5) were significantly correlated withdysphagia. For I-PCM doses, Dmean (p = 0.037, r=0.5) and Dmax (p = 0.019, r=0.5) were correlated.Cut-off values from ROC analysis and logistic regression are shown in Table 2.
Conclusion
Our findings indicate that both esophageal and PCM doses are significant predictors of acutedysphagia during RT for NCa. Incorporating PCM dose constraints into treatment planning mayreduce dysphagia and improve treatment tolerance.