Patient- and treatment-related risk factors associated with neck muscle spasm in nasopharyngeal carcinoma patients after intensity-modulated radiotherapy.

Abstract

BACKGROUND:

To evaluate the incidence of neck muscle spasm in nasopharyngeal carcinoma (NPC) patients that received intensity-modulated radiotherapy (IMRT), and to analyse the patient- and treatment-related risk factors associated with neck muscle spasm.

METHODS:

A sample of 152 IMRT-treated, biopsy-proven, nondisseminated NPC patients were retrospectively analysed. All had documented IMRT treatment plans and had returned for follow-up review at 4 years post-radiotherapy. Spasm of the sternocleidomastoid (SCM) muscle was graded from 0 to 3 (absent to severe) and this grade served as the clinical endpoint. Risk factors were identified using logistic regression analysis.

RESULTS:

Within 4 years of radiotherapy, neck muscle spasm developed in 23.68% of the patients; Grades 0, 1, 2 and 3 were respectively assigned to 83.55, 7.57, 6.58 and 2.30% of assessed SCMs. Multivariate analysis indicated that gender, N stage, V60 (percentage of SCM volume that received >60 Gy) were independent prognostic variables, and that the optimal threshold for using V60 to predict neck muscle spasm was 61.92% (sensitivity = 0.900, specificity = 0.953).

CONCLUSIONS:

Gender, N stage and V60 were independent predictive factors for post-radiotherapy neck muscle spasm, and a V60 of ≤61.92% in the SCM was relatively safe.

• Authors: Lu-Lu Zhang, Guan-Qun Zhou, Zhen-Yu Qi, Xiao-Jun He, Jia-Xiang Li, Ling-Long Tang, Yan-Ping Mao, Ai-Hua Lin, Jun Ma, Ying Sun
• Journal: BMC cancer (BMC Cancer) Vol. 17 Issue 1 Pg. 788 (Nov 23 2017) ISSN: 1471-2407 [Electronic] England
• PMID: 29169335 (Publication Type: Journal Article)

Topics

• Adult
• Carcinoma (complications, diagnosis, epidemiology, radiotherapy)
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Nasopharyngeal Carcinoma
• Nasopharyngeal Neoplasms (complications, diagnosis, epidemiology, radiotherapy)
• Neck Muscles (physiopathology)
• Neoplasm Staging
• ROC Curve
• Radiotherapy Dosage
• Radiotherapy, Intensity-Modulated (adverse effects)
• Risk Factors
• Spasm (diagnosis, epidemiology, etiology)
• Young Adult