Pharyngoesophageal stricture after treatment for head and neck cancer

Authors:
  • TGTessa A. Goldsmith
    Tessa A. Goldsmith
  • AHAllison S. Holman
    Allison S. Holman
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Abstract
Background: The purpose of this study was to report the risk of pharyngoesophageal stricture after treatment for head and neck cancer.Methods: Human studies on radiation therapy with or without chemotherapy for head and neck cancer published in peer‐reviewed journals with assessment of pharyngoesophageal stricture with barium swallow or endoscopy were included.Results: A total of 4727 patients from 26 studies treated between 1989 and 2008 were eligible for analysis. The reported overall risk of stricture was 7.2%. The risks of pharyngoesophageal stricture in both conventional and intensity‐modulated radiation therapy (IMRT) studies were 5.7% and 16.7%, respectively (p < .001). Use of concurrent (p < .001) and taxane (p = .01) chemotherapy was associated with the IMRT technique. Prospective studies reported a 3.3‐fold increased risk of stricture compared with that of retrospective studies (odds ratio: 3.3; 95% confidence interval: 2.3–4.8; p < .001).Conclusions: Pharyngoesophageal stricture after IMRT and chemotherapy treatment for head and neck cancer is not uncommon. Videofluoroscopic swallow study should be performed prospectively to evaluate swallowing function. © 2011 Wiley Periodicals, Inc. Head Neck, 2012

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