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Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation.
Lee, Walter T; Akst, Lee M; Adelstein, David J; Saxton, Jerrod P; Wood, Benjamin G; Strome, Marshall; Butler, Robert S; Esclamado, Ramon M.
Afiliación
  • Lee WT; Head and Neck Institute, Cleveland Clinic Foundation, Ohio Desk A71, 9500 Euclid Ave., Cleveland, Ohio 44195, USA. leew@ccf.org
Head Neck ; 28(9): 808-12, 2006 Sep.
Article en En | MEDLINE | ID: mdl-16732601
BACKGROUND: Concurrent chemoradiation therapy has been demonstrated to be effective as an organ-sparing treatment for select advanced head and neck squamous cell carcinoma (HNSCC). However, this treatment modality is not without side effects. One side effect is the formation of upper esophageal strictures. As concurrent chemoradiation treatment is used more frequently, it is important to identify risk factors associated with stricture formation. METHODS: A retrospective chart review of all patients who had undergone definitive concurrent chemoradiation treatment between 1989 and 2002 was performed. Exclusion criteria included death within 1 year or persistent/recurrent disease that required surgical salvage at the primary site. The outcome measure was stricture formation as determined by both objective findings (barium swallow or endoscopy) and the need for dilation after treatment. RESULTS: Of the 222 patients in this cohort, there were enough data for 199 patients to assess for stricture formation. Strictures developed in a total of 41 patients (21%). Significant predictive factors were a twice-daily (BID) radiation fractionation (p = .007), female sex (p = .015), and a hypopharyngeal primary site (p = .01). Age and tumor extent were not significant factors in stricture formation (p = .15 and p = .23, respectively). CONCLUSIONS: Symptomatic strictures occur in 21% of patients undergoing concurrent chemoradiation for HNSCC. Female sex, BID radiation fractionation, and a hypopharyngeal primary site are significant predictive factors for stricture formation.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos por Radiación / Carcinoma de Células Escamosas / Estenosis Esofágica / Neoplasias de Cabeza y Cuello / Hipofaringe Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Head Neck Asunto de la revista: NEOPLASIAS Año: 2006 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos por Radiación / Carcinoma de Células Escamosas / Estenosis Esofágica / Neoplasias de Cabeza y Cuello / Hipofaringe Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Head Neck Asunto de la revista: NEOPLASIAS Año: 2006 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos