A new standard of radiation therapy for pharyngeal cancer is proposed
Researchers recommend considering dysphagia dose-optimized radiation therapy as a new standard of care for patients with pharyngeal cancer. This has the potential to reduce associated complications.Researchers from the Cancer Research Institutes in London and Bristol and a specialist cancer center in London compared the safety of two methods of radiation therapy in patients with oropharyngeal or laryngeal cancer. The results of the study, in which participants received either standard intensity-modulated radiation therapy or therapy using the same modality, only dose-optimized for dysphagia, are published in The Lancet: Oncology.
They analyzed two years of data from 118 adult patients with diagnosed oropharyngeal or laryngeal cancer at stages T1-4, N0-3, M0, with a WHO status score of 0-1 and no prior swallowing disorder. All received radiation therapy at 22 centers in Ireland and the UK. The mean age of the participants was 57 years and 20% were female.
Participants were evenly divided into two groups: standard therapy and a new method with dose optimization by dysphagia. The treatment regimen included 30 fractions over six weeks. The radiation dose was 65 Gy to the tumor area and 54 Gy to the rest of the pharynx and lymph nodes at risk of microscopic disease. The dysphagia dose optimization group used a mean dose limitation of 50 Gy or less to the muscles involved in swallowing.
Researchers assessed outcomes 12 months after radiation therapy using the Anderson Dysphagia Questionnaire. The dysphagia-optimized radiation therapy group had better swallowing impairment scores, with a mean score of 77.7 compared to 70.6 in the standard therapy group. Moreover, the new radiation therapy method showed a reduced incidence of adverse events including dry mouth and dysphagia: 5% compared to 15% in the standard radiation therapy group.
The authors recommend considering the dysphagia dose-optimized method as a new standard of care for patients receiving radiation therapy for pharyngeal cancer.