Base of tongue volume and dose as predictors of late dysphagia after definitive or adjuvant radiotherapy for oral cavity squamous cell carcinoma
Abstract
Background and purpose: Radiation-induced dysphagia is a major determinant of quality of life in patients treated for oral cavity squamous cell carcinoma (OCSCC). While dose to the pharyngeal constrictor muscles has been extensively investigated, the base of tongue (BOT) remains poorly studied. This study aimed to evaluate the association between BOT volume and dose–volume parameters and late dysphagia. Material and methods: Fifty-two patients with OCSCC treated with volumetric modulated arc therapy (VMAT) between 2019 and 2023 were retrospectively analyzed. All patients had a prophylactic feeding tube (FT) placed before VMAT. The base of tongue was delineated using an artificial intelligence-based segmentation algorithm and reviewed by a senior radiation oncologist. Late dysphagia was defined as prolonged FT dependency using the cohort-specific 75th percentile (>442.5 days). Volumetric and dose/volume parameters of the BOT (D0%–D100%) were analyzed using logistic regression, receiver operating characteristic (ROC) curve analysis, and Kaplan–Meier methods. Results: The median BOT volume for the entire cohort was 18.4 cm3 (interquartile range [IQR]: 15.7–21.3 cm3). Patients with late dysphagia had smaller BOT volumes than those without (15.9 vs. 19.5 cm3, p =0.02). A BOT volume <19.12 cm3 was associated with increased dysphagia risk. No dose/volume parameter reached statistical significance, although a trend suggested lower risk for a BOT D50% <52.2 Gy (p =0.21). A combined model integrating BOT volume and D50% achieved an area under the curve (AUC) of 0.74 (95% CI: 0.61–0.87). Conclusions: Smaller BOT volume was associated with increased risk of prolonged FT dependency after radiotherapy for OCSCC. BOT dose metrics were not significant but showed hypothesis-generating trends that warrant validation in larger cohorts and dose-optimization studies.
Related
- Postoperative radiotherapy after tracheal reconstruction with cryopreserved aortic allograft for adenoid cystic carcinoma
- Adjuvant donafenib plus sintilimab therapy for hepatocellular carcinoma at high risk of recurrence after resection: a retrospective cohort study
- The SChISM study: Circulating cell-free DNA size profiles as predictors of progression in advanced carcinoma treated with immune-checkpoint inhibitors
- Liver transplantation outcomes, systemic immune–inflammatory phenotype, and predictors of hepatocellular carcinoma recurrence in an HBV/HDV-endemic region: a retrospective cohort study
- Histopathologic spectrum of focal liver lesions diagnosed by ultrasound-guided percutaneous liver biopsy and predictors of hepatocellular carcinoma: A single-center experience from Sub-Saharan Africa
BibTeX
@article{azria2026base,
title = {{Base of tongue volume and dose as predictors of late dysphagia after definitive or adjuvant radiotherapy for oral cavity squamous cell carcinoma}},
author = {Joseph Azria and Arnaud Beddok and Esteban Brenet and Delphine Antoni and Laurence Auzeau and Nathaniel Assouly and Marine Fontaine and Sofiane Guendouzen and Jean-Claude Merol and Yacine Merrouche and Philippe Guilbert and Antonio da Silva Ribeiro Mota},
journal = {Physics and Imaging in Radiation Oncology},
year = {2026},
month = sep,
doi = {10.1016/j.phro.2026.101038},
url = {https://univ-reims.hal.science/hal-05735280v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Base of tongue volume and dose as predictors of late dysphagia after definitive or adjuvant radiotherapy for oral cavity squamous cell carcinoma
AU - Joseph Azria
AU - Arnaud Beddok
AU - Esteban Brenet
AU - Delphine Antoni
AU - Laurence Auzeau
AU - Nathaniel Assouly
AU - Marine Fontaine
AU - Sofiane Guendouzen
AU - Jean-Claude Merol
AU - Yacine Merrouche
AU - Philippe Guilbert
AU - Antonio da Silva Ribeiro Mota
PY - 2026
DA - 2026/09/02
JO - Physics and Imaging in Radiation Oncology
DO - 10.1016/j.phro.2026.101038
UR - https://univ-reims.hal.science/hal-05735280v1
AB - Background and purpose: Radiation-induced dysphagia is a major determinant of quality of life in patients treated for oral cavity squamous cell carcinoma (OCSCC). While dose to the pharyngeal constrictor muscles has been extensively investigated, the base of tongue (BOT) remains poorly studied. This study aimed to evaluate the association between BOT volume and dose–volume parameters and late dysphagia. Material and methods: Fifty-two patients with OCSCC treated with volumetric modulated arc therapy (VMAT) between 2019 and 2023 were retrospectively analyzed. All patients had a prophylactic feeding tube (FT) placed before VMAT. The base of tongue was delineated using an artificial intelligence-based segmentation algorithm and reviewed by a senior radiation oncologist. Late dysphagia was defined as prolonged FT dependency using the cohort-specific 75th percentile (>442.5 days). Volumetric and dose/volume parameters of the BOT (D0%–D100%) were analyzed using logistic regression, receiver operating characteristic (ROC) curve analysis, and Kaplan–Meier methods. Results: The median BOT volume for the entire cohort was 18.4 cm3 (interquartile range [IQR]: 15.7–21.3 cm3). Patients with late dysphagia had smaller BOT volumes than those without (15.9 vs. 19.5 cm3, p =0.02). A BOT volume <19.12 cm3 was associated with increased dysphagia risk. No dose/volume parameter reached statistical significance, although a trend suggested lower risk for a BOT D50% <52.2 Gy (p =0.21). A combined model integrating BOT volume and D50% achieved an area under the curve (AUC) of 0.74 (95% CI: 0.61–0.87). Conclusions: Smaller BOT volume was associated with increased risk of prolonged FT dependency after radiotherapy for OCSCC. BOT dose metrics were not significant but showed hypothesis-generating trends that warrant validation in larger cohorts and dose-optimization studies.
SN - 2405-6316
ER -