Factors associated with pharyngoesophageal stricture in patients treated with concurrent chemotherapy and radiation therapy for oropharyngeal squamous cell carcinoma

Simon R. Best, Patrick K. Ha, Ray G. Blanco, John R. Saunders, Eva S. Zinreich, Marshall A. Levine, Sara I. Pai, Melissa Walker, Jaclyn Trachta, Karen Ulmer, Peter Murakami, Richard Thompson, Joseph A. Califano, Barbara P. Messing

Research output: Contribution to journalArticlepeer-review

Abstract

Background The purpose of this study was to elucidate factors associated with pharyngoesophageal strictures after treatment for head and neck squamous cell carcinoma (SCC). Methods We conducted a retrospective review of patients receiving cisplatin and 5-fluorouracil chemotherapy combined with concurrent hyperfractionated radiation therapy for oropharyngeal squamous cell carcinoma. Results Strictures developed in 13 of 67 patients (19%). Strictures were associated with tumor location (tonsil vs base of tongue; p =.03), neck dissection after completion of therapy (p =.03), and the duration of treatment-induced mucositis (weeks with mucositis grade ≥2; National Cancer Institute (NCI) Common Toxicity Criteria; p <.001). Age, sex, race, tumor stage, nodal stage, American Joint Committee on Cancer (AJCC) stage, human papillomavirus (HPV) status, smoking, radiation dose, maximum severity of mucositis, amifostine use, and pretreatment swallow dysfunction were not significantly associated with stricture. In multivariate analysis, only duration of mucositis, after controlling for age, sex, and tumor location, remained highly significant (p <.01). Conclusion The duration of treatment-related mucositis is an independent risk factor for stricture formation in patients with oropharyngeal SCC treated with concurrent chemotherapy and radiation therapy.

Original languageEnglish (US)
Pages (from-to)1727-1734
Number of pages8
JournalHead and Neck
Volume33
Issue number12
DOIs
StatePublished - Dec 2011

Keywords

  • chemoradiation
  • oropharyngeal
  • pharyngoesophageal
  • squamous cell carcinoma
  • stricture

ASJC Scopus subject areas

  • Otorhinolaryngology

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