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• W2077163025 abstract "Radiation therapy (RT) dose de-escalation has been hypothesized to decrease swallow complications. Evidence suggests a potential dose threshold of 55-60 Gy for injury to the constrictor muscles (RTOG grade 4). JHU0988 is a phase II study reducing the RT dose in patients with oropharyngeal squamous cell carcinomas (OPSCC) to the portion of the primary tumor overlapping the pharyngeal constrictors and larynx to 63 Gy. We sought to evaluate the swallow function of 0988 patients to determine the adequacy of this dose reduction. Patients with previously untreated HPV- or p16 positive OPSCC, T1-2, N0-2a or T1-3, N2-3, M0, ECOG PS0-1 were prospectively enrolled. Treatment consisted RT alone (63 Gy) or concurrent weekly (40 mg/m2) cisplatin to 63 Gy to the primary tumor. Nodal metastases received 70 Gy in 35 fractions. Prospective swallowing assessment was performed at baseline, 1-2 months and one year following treatment completion. The Penetration Aspiration Scale (PAS) was used to objectively quantify entrance of the bolus material into the laryngeal vestibule and patient response to this material. Scores were considered normal if < 3 and abnormal if ≥3. A historical control group of OPSCC patients treated with CRT and who underwent post-RT videofluoroscopic swallowing studies (VFSS) from 2007-2010. To control for potential selection bias that could influence PAS due to the dosimetry to the swallowing muscles, we grouped patients in 0988 and the control cohort into 4 groups: A: T1/tonsil, B: T2+/tonsil, C: T1/BOT, and D: T2/BOT. Descriptive and analytic statistics using Pearson chi-square test without Yate correction was performed (R 2.15.2) and was used to evaluate the characteristics between the 0988 and the control cohort. A total of 63 patients were analyzed. The median follow-up for the 0988 patients (n = 28) was 25 months (1-33 mos) with 90% receiving CRT. The median time to swallow evaluation was 2 months (0988) vs 4 months (control). The number of patients in groups A, B, C and D were not significantly different when comparing 0988 vs control (p = .87). Dose reduction for OPSCC patients may be associated with improved post RT PAS scores.Oral Scientific Abstract 348; TablePAS scoresNormal PAS (PAS = < 2) n (percentage)Abnormal PAS (PAS > 2) n (percentage)P valueCohort 098822 (84.6%)4 (15.4%) Control23 (62.2%)14 (37.8%)P = .05Group 1 (T1/Tonsil)14 (37.8%)3 (33.3%) 2 (T2+/Tonsil)19 (73.1%)7 (26.9%) 3 (T1(BOT)10 (76.9%)3 (23.1%) 4 (T2+/BOT)10 (66.7%)5 (33.3%)P = NS Open table in a new tab" @default.
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• W2077163025 date "2013-10-01" @default.
• W2077163025 modified "2023-10-16" @default.
• W2077163025 title "Swallow Function in Patients With Oropharyngeal Squamous Cell Carcinomas Treated With Radiation Therapy Dose De-escalation" @default.
• W2077163025 doi "https://doi.org/10.1016/j.ijrobp.2013.06.364" @default.
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