{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T21:26:34Z","timestamp":1760909194234},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,17]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Long-term side effects after radiotherapy for organ preservation \u2018could deteriorate\u2019 the laryngeal function. This study intended to identify the incidence of severe late dysphagia following the multimodal treatment for stage III\/IV laryngeal and hypopharyngeal cancer \u2018to evaluate the function of larynx\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of patients successfully treated for laryngeal and hypopharyngeal cancer with a multimodal approach, including radiotherapy, were retrospectively analyzed. \u2018Functional larynx was defined as tolerable oral diet without severe late dysphagia or tracheostoma\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 99 patients with a median follow-up period of 72\u00a0months. \u2018Tracheostomy during the follow-up period was required in only one patient due to aspiration pneumonia, and dysphagia is the main determinant for functional larynx\u2019. The probability of maintaining functional larynx was 63% for 10\u00a0years, when the treatment was started with radiotherapy or concurrent chemoradiotherapy. In upfront surgery (operation first and adjuvant radiotherapy\/concurrent chemoradiotherapy) group, 37% of patients required total laryngectomy as primary treatment and 43% of patients could maintain laryngeal function for 10\u00a0years. And severe late dysphagia in the latter group developed mainly after laryngeal preservation surgery. The patients aged \u226565\u00a0years showed significantly higher incidence of dysphagia. Severe late dysphagia was very rare in laryngeal cancer successfully cured with radiotherapy\/concurrent chemoradiotherapy (1\/25, 4%); however, it gradually increased over time in hypopharyngeal cancer patients showing a statistically significant difference from laryngeal cancer patients (P\u00a0=\u00a00.040).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Severe late dysphagia occurred in 19.2% of patients treated for laryngeal and hypopharyngeal cancers, regardless of whether treatment started with radiotherapy\/concurrent chemoradiotherapy or surgery.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jjco\/hyz158","type":"journal-article","created":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T11:18:31Z","timestamp":1570015111000},"page":"185-192","source":"Crossref","is-referenced-by-count":20,"title":["Severe late dysphagia after multimodal treatment of stage III\/IV laryngeal and hypopharyngeal cancer"],"prefix":"10.1093","volume":"50","author":[{"given":"Gene","family":"Huh","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soon-Hyun","family":"Ahn","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Girl","family":"Suk","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Hyung","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won Shik","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seong Keun","family":"Kwon","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chan-Young","family":"Ock","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhumsuk","family":"Keam","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae Seog","family":"Heo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Ho","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Gyun","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"2020021709393948200_ref1","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1056\/NEJM199106133242402","article-title":"Group* DoVALCS. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer","volume":"324","year":"1991","journal-title":"N Engl J Med"},{"key":"2020021709393948200_ref2","first-page":"207","article-title":"Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer","volume":"8","author":"Forastiere","year":"2004","journal-title":"Cancer Radiother"},{"key":"2020021709393948200_ref3","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1093\/jnci\/88.13.890","article-title":"Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of cancer phase III trial","volume":"88","author":"Lefebvre","year":"1996","journal-title":"JNCI"},{"key":"2020021709393948200_ref4","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1002\/cncr.29241","article-title":"Long-term outcomes after surgical or nonsurgical initial therapy for patients with T4 squamous cell carcinoma of the larynx: a 3-decade survey","volume":"121","author":"Rosenthal","year":"2015","journal-title":"Cancer"},{"key":"2020021709393948200_ref5","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1002\/lary.20477","article-title":"The effect of treatment on survival in patients with advanced laryngeal carcinoma","volume":"119","author":"Gourin","year":"2009","journal-title":"Laryngoscope"},{"key":"2020021709393948200_ref6","doi-asserted-by":"crossref","first-page":"E2035","DOI":"10.1002\/hed.24374","article-title":"Clinical outcomes in patients with T4 laryngeal cancer treated with primary radiotherapy versus primary laryngectomy","volume":"38","author":"Vengalil","year":"2016","journal-title":"Head Neck"},{"key":"2020021709393948200_ref7","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/S0140-6736(00)90011-4","article-title":"Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data","volume":"355","author":"Pignon","year":"2000","journal-title":"Lancet"},{"key":"2020021709393948200_ref8","doi-asserted-by":"crossref","first-page":"3543","DOI":"10.21873\/anticanres.12626","article-title":"Definitive chemoradiation in locally advanced squamous cell carcinoma of the hypopharynx: long-term outcomes and toxicity","volume":"38","author":"Juloori","year":"2018","journal-title":"Anticancer Res"},{"key":"2020021709393948200_ref9","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.ijrobp.2012.03.005","article-title":"Hypopharyngeal dose is associated with severe late toxicity in locally advanced head-and-neck cancer: an RTOG analysis","volume":"84","author":"Machtay","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2020021709393948200_ref10","doi-asserted-by":"crossref","first-page":"3582","DOI":"10.1200\/JCO.2007.14.8841","article-title":"Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis","volume":"26","author":"Machtay","year":"2008","journal-title":"J Clin Oncol"},{"key":"2020021709393948200_ref11","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.oraloncology.2016.03.014","article-title":"Severe late dysphagia and cause of death after concurrent chemoradiation for larynx cancer in patients eligible for RTOG 91-11","volume":"57","author":"Ward","year":"2016","journal-title":"Oral Oncol"},{"key":"2020021709393948200_ref12","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1200\/JCO.2012.43.6097","article-title":"Long-term results of RTOG 91-11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer","volume":"31","author":"Forastiere","year":"2013","journal-title":"J Clin Oncol"},{"key":"2020021709393948200_ref13","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1002\/hed.21218","article-title":"Impact of demographics, tumor characteristics, and treatment factors on swallowing after (chemo) radiotherapy for head and neck cancer","volume":"32","author":"Frowen","year":"2010","journal-title":"Head Neck J Sci Spec Head Neck"},{"key":"2020021709393948200_ref14","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.radonc.2011.08.009","article-title":"Predictive modelling for swallowing dysfunction after primary (chemo) radiation: results of a prospective observational study","volume":"105","author":"Christianen","year":"2012","journal-title":"Radiother Oncol"},{"key":"2020021709393948200_ref15","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/j.1442-2050.2011.01210.x","article-title":"Oropharyngeal dysphagia: pathophysiology and diagnosis for the anniversary issue of diseases of the Esophagus","volume":"25","author":"Logemann","year":"2012","journal-title":"Dis Esophagus"},{"key":"2020021709393948200_ref16","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.radonc.2007.07.009","article-title":"Dysphagia disorders in patients with cancer of the oropharynx are significantly affected by the radiation therapy dose to the superior and middle constrictor muscle: a dose-effect relationship","volume":"85","author":"Levendag","year":"2007","journal-title":"Radiother Oncol"},{"key":"2020021709393948200_ref17","doi-asserted-by":"crossref","first-page":"4964","DOI":"10.1002\/cam4.1756","article-title":"Patient choice for high-volume center radiation impacts head and neck cancer outcome","volume":"7","author":"Naghavi","year":"2018","journal-title":"Cancer Med"},{"key":"2020021709393948200_ref18","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1001\/archotol.129.1.44","article-title":"Outcome of salvage total laryngectomy following organ preservation therapy: the radiation therapy oncology group trial 91-11","volume":"129","author":"Weber","year":"2003","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"2020021709393948200_ref19","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1159\/000130870","article-title":"Proximal esophageal stenosis in head and neck cancer patients after total laryngectomy and radiation","volume":"70","author":"Vu","year":"2008","journal-title":"ORL"}],"container-title":["Japanese Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jjco\/article-pdf\/50\/2\/185\/32499733\/hyz158.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jjco\/article-pdf\/50\/2\/185\/32499733\/hyz158.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T11:34:03Z","timestamp":1721820843000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jjco\/article\/50\/2\/185\/5618817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,11]]},"references-count":19,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,11,11]]},"published-print":{"date-parts":[[2020,2,17]]}},"URL":"https:\/\/doi.org\/10.1093\/jjco\/hyz158","relation":{},"ISSN":["1465-3621"],"issn-type":[{"value":"1465-3621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,2]]},"published":{"date-parts":[[2019,11,11]]}}}