Abstract：
PURPOSE:A systematic review to establish what evidence is available for swallowing outcomes following IMRT for head and neck cancer. METHODS:Online electronic databases were searched to identify papers published in English from January 1998 to December 2009. Papers were independently appraised by two reviewers for methodological quality, method of swallowing evaluation and categorized according to the World Health Organisation's International Classification of Health Functions. The impact of radiation dose to dysphagia aspiration risk structures (DARS) was also evaluated. RESULTS:Sixteen papers met the inclusion criteria. The literature suggests that limiting the radiation dose to certain structures may result in favourable swallowing outcomes. Methodological limitations included variable assessment methods and outcome measures and heterogeneity of patients. There are only limited prospective data, especially where pre-treatment measures have been taken and compared to serial post-treatment assessment. CONCLUSIONS:Few studies have investigated the impact of IMRT on swallow function and the impact on everyday life. Initial studies have reported potential benefits but are limited in terms of study design and outcome data. Further well designed, prospective, longitudinal swallowing studies including multidimensional evaluation methods are required to enable a more comprehensive understanding of dysphagia complications and inform pre-treatment counselling and rehabilitation planning.
journal_name
Oral Oncoljournal_title
Oral oncologyauthors
Roe JW,Carding PN,Dwivedi RC,Kazi RA,Rhys-Evans PH,Harrington KJ,Nutting CMdoi
10.1016/j.oraloncology.2010.07.012subject
Has Abstractpub_date
2010-10-01 00:00:00pages
727-33issue
10eissn
1368-8375issn
1879-0593pii
S1368-8375(10)00228-9journal_volume
46pub_type
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