Swallowing Outcomes Post Volumetric Modulated Arc Therapy for Head and Neck Cancer Patients Using MD Anderson Dysphagia Inventory: An Institutional Experience

Background]MD Anderson dysphagia inventory (MDADI) is a dysphagiaspecific quality of life (QOL) questionnaire for patients with head and neck (H N) cancer.[Objectives]This study aimed at ascertaining the impact of dysphagia on the QOL of patients undergoing radiation therapy for H N cancer with curative intent.[Methods]This prospective observational study was conducted at a tertiary care hospital in India. Patients with H N cancer meeting the selection criteria were enrolled in this study. The patients completed the MDADI questionnaire administered to them at the treatment completion and 3 to 6 months after the treatment. The chisquare test, Independentsamples i t /i test, and Spearman correlation coefficients were used for analysis.[Results]After the treatment, the total MDADI score was significantly related to the constrictor mean dose (P = 0.035) and larynx mean dose (P = 0.050). This association was maintained 3 months after the treatment by the constrictors and larynx mean dose (P lt; 0.05). Keeping the dose constraints for constrictors lt; 50 Grays (Gy) and larynx lt; 45 Gy resulted in a better QOL. The mean doses to the cervical esophagus did not statistically correlate with the questionnaire scores. At 6 months after the treatment, a correlation was seen only with the larynx mean doses. Spearman’s rank analysis was significantly correlated to the total as well as individual MDADI scores.[Conclusions]MDADI scores provided significant insights into the dysphagiarelated QOL for patients with H N cancer. Modern techniques like volumetric modulated arc therapy (VMAT) are translated into an improved QOL for patients and justify their use. Furthermore, parameters like V30/V40 would have been even more valuable and should be undertaken in future studies.