Abstract
BackgroundTo evaluate the incidence of neck muscle spasm in nasopharyngeal carcinoma (NPC) patients that received intensity-modulated radiotherapy (IMRT), and to analyse the patient- and treatment-related risk factors associated with neck muscle spasm.MethodsA sample of 152 IMRT-treated, biopsy-proven, nondisseminated NPC patients were retrospectively analysed. All had documented IMRT treatment plans and had returned for follow-up review at 4 years post-radiotherapy. Spasm of the sternocleidomastoid (SCM) muscle was graded from 0 to 3 (absent to severe) and this grade served as the clinical endpoint. Risk factors were identified using logistic regression analysis.ResultsWithin 4 years of radiotherapy, neck muscle spasm developed in 23.68% of the patients; Grades 0, 1, 2 and 3 were respectively assigned to 83.55, 7.57, 6.58 and 2.30% of assessed SCMs. Multivariate analysis indicated that gender, N stage, V60 (percentage of SCM volume that received >60 Gy) were independent prognostic variables, and that the optimal threshold for using V60 to predict neck muscle spasm was 61.92% (sensitivity = 0.900, specificity = 0.953).ConclusionsGender, N stage and V60 were independent predictive factors for post-radiotherapy neck muscle spasm, and a V60 of ≤61.92% in the SCM was relatively safe.
Highlights
To evaluate the incidence of neck muscle spasm in nasopharyngeal carcinoma (NPC) patients that received intensity-modulated radiotherapy (IMRT), and to analyse the patient- and treatment-related risk factors associated with neck muscle spasm
With the 5-year overall survival rate for NPC patients treated with IMRT increasing to 79.6% [6], focus has shifted to improving the quality of life of these survivors, who can experience late adverse events such as cervical subcutaneous fibrosis, hearing loss and skin dystrophy [7]
Pre-treatment characteristics of patients and incidence of neck muscle spasms Of the 152 NPC patients included in the final study, 114 were men and 38 were woman
Summary
To evaluate the incidence of neck muscle spasm in nasopharyngeal carcinoma (NPC) patients that received intensity-modulated radiotherapy (IMRT), and to analyse the patient- and treatment-related risk factors associated with neck muscle spasm. NPC is one of the most radiosensitive cancers, and radiation therapy (RT) is usually the definitive treatment [2]. Intensity-modulated radiotherapy (IMRT) has become accepted as a more advanced radiation technique for treatment of NPC [3,4,5]. With the 5-year overall survival rate for NPC patients treated with IMRT increasing to 79.6% [6], focus has shifted to improving the quality of life of these survivors, who can experience late adverse events such as cervical subcutaneous fibrosis, hearing loss and skin dystrophy [7]
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