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Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation.

Publication ,  Journal Article
Lee, WT; Akst, LM; Adelstein, DJ; Saxton, JP; Wood, BG; Strome, M; Butler, RS; Esclamado, RM
Published in: Head Neck
September 2006

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.

Duke Scholars

Published In

Head Neck

DOI

ISSN

1043-3074

Publication Date

September 2006

Volume

28

Issue

9

Start / End Page

808 / 812

Location

United States

Related Subject Headings

  • Radiotherapy
  • Radiation Injuries
  • Otorhinolaryngology
  • Male
  • Hypopharynx
  • Humans
  • Head and Neck Neoplasms
  • Female
  • Esophageal Stenosis
  • Constriction, Pathologic
 

Citation

APA
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ICMJE
MLA
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Lee, W. T., Akst, L. M., Adelstein, D. J., Saxton, J. P., Wood, B. G., Strome, M., … Esclamado, R. M. (2006). Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation. Head Neck, 28(9), 808–812. https://doi.org/10.1002/hed.20427
Lee, Walter T., Lee M. Akst, David J. Adelstein, Jerrod P. Saxton, Benjamin G. Wood, Marshall Strome, Robert S. Butler, and Ramon M. Esclamado. “Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation.Head Neck 28, no. 9 (September 2006): 808–12. https://doi.org/10.1002/hed.20427.
Lee WT, Akst LM, Adelstein DJ, Saxton JP, Wood BG, Strome M, et al. Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation. Head Neck. 2006 Sep;28(9):808–12.
Lee, Walter T., et al. “Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation.Head Neck, vol. 28, no. 9, Sept. 2006, pp. 808–12. Pubmed, doi:10.1002/hed.20427.
Lee WT, Akst LM, Adelstein DJ, Saxton JP, Wood BG, Strome M, Butler RS, Esclamado RM. Risk factors for hypopharyngeal/upper esophageal stricture formation after concurrent chemoradiation. Head Neck. 2006 Sep;28(9):808–812.
Journal cover image

Published In

Head Neck

DOI

ISSN

1043-3074

Publication Date

September 2006

Volume

28

Issue

9

Start / End Page

808 / 812

Location

United States

Related Subject Headings

  • Radiotherapy
  • Radiation Injuries
  • Otorhinolaryngology
  • Male
  • Hypopharynx
  • Humans
  • Head and Neck Neoplasms
  • Female
  • Esophageal Stenosis
  • Constriction, Pathologic