A quasi-experimental study comparing dysphagia optimized intensity modulated radiotherapy (Do-IMRT) versus standard intensity modulated radiotherapy (S-IMRT).

Dysphagiafollowing chemoradiation for patients with head and neck cancers have led to adevastating impact on their quality of life, as it leads to a change in thetype of diet, prolongation of meal times, or even a need for tube feeding. Althoughother significant toxicities have been reduced by developments in radiationtechniques, dysphagia continues to be a challenge for radiation oncologists. Manyphase II studies have shownthat reducing the radiation dose to critical swallowing structures such as thepharyngeal constrictor muscle and supraglottic larynx can lead to betteroutcomes; however, there are limited prospective studies to have verified thisbenefit. The aim of this study is to compare the effects of standard intensitymodulated radiotherapy (S-IMRT) and dysphagia-optimized intensity modulatedradiotherapy (Do-IMRT) on severity of dysphagia aswell as immediate treatment response in patientsundergoing concurrent chemoradiation for oropharyngeal, hypopharyngeal, andsupraglottic laryngeal cancer (T2-T4, N+, M0). The swallowingfunction will be assessed by means of a modified barium swallow techniqueperformedsix months aftertreatment and the treatment response will be assessed by comparing the PET-CTscan taken six months aftertreatment with the pre-treatment PET-CT scan.