Correlation of health-related quality of life with dose to dysphagia aspiration-related structures in head and neck cancer patients treated with intensity-modulated radiotherapy.

Authors

Gagan Saini, Shreebha Hari, Rashmi Shukla, Sowrabh Arora

Published in

Journal of cancer research and therapeutics. Volume 22. Issue 3. Pages 488-496. Apr 01, 2026. Epub Aug 14, 2026.

Abstract

Head and neck cancer (HNC) ranks among the most prevalent malignancies globally, with a significant burden in India. While intensity-modulated radiotherapy (IMRT) has improved tumor control, it has not entirely mitigated treatment-related toxicities, particularly dysphagia. Dysphagia-aspiration-related structures (DARSs) play a critical role in post-treatment swallowing function. This study evaluates the correlation between radiation dose to DARS and health-related quality of life (HRQoL) in HNC patients.
A prospective, longitudinal study was conducted on 47 histologically confirmed HNC patients undergoing IMRT. Quality of life was assessed using the EORTC QLQ-C30 and QLQ-H and N35 questionnaires at multiple time points (pretreatment, midtreatment, and post-treatment follow-up). Radiation dosimetry was analyzed for five key swallowing structures-pharyngeal constrictors, supraglottic larynx, and cervical esophagus (CE). Statistical correlations were established between dose-volume metrics and patient-reported QoL outcomes.
Higher radiation dose exposure (V40Gy) to superior and middle pharyngeal constrictors significantly correlated with reduced global health status and increased swallowing dysfunction at 12 and 48 weeks post-treatment (P < 0.05). Dose to the CE was associated with increased pain scores across all time points. Persistent xerostomia and sticky saliva symptoms were observed, particularly in oral cavity cancer patients. Emotional and cognitive functioning declined significantly at later follow-ups, indicating a multifactorial impact of treatment.
Radiation dose to DARS has a measurable impact on post-treatment QoL, particularly swallowing function and pain. Reducing intermediate-dose exposure to pharyngeal constrictors may improve long-term outcomes. Future treatment planning strategies should incorporate DARS-sparing techniques and optimize IMRT approaches to enhance QoL while maintaining tumor control.

PMID:
42617014
Bibliographic data and abstract were imported from PubMed on 20 Aug 2026.

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