Validation of the Total Dysphagia Risk Score (TDRS) as a predictive measure for acute swallowing dysfunction induced by chemoradiotherapy for head and neck cancers

Background and purposeMethods for predicting acute swallowing dysfunction in patients with head and neck cancers undergoing definitive chemoradiotherapy have not been established. We investigated the validity of the Total Dysphagia Risk Score (TDRS) as a predictive measure for this morbidity.Materials and methodsForty-seven patients with head and neck cancers who underwent definitive chemoradiotherapy between December 1998 and March 2006 were reviewed retrospectively. Median age was 63 years (range, 16–81). Almost all patients underwent platinum-based concomitant chemoradiotherapy. Factors of the TDRS were as follows: T-classification, neck irradiation, weight loss, primary tumour site and treatment modality. Patients were classified into three risk groups according to the TDRS.ResultsSwallowing dysfunction was observed in 27 patients (57%) as RTOG grade 2 or higher acute morbidity. This classification was significantly associated with grade 2 or higher acute swallowing dysfunction (P < 0.001). In ROC (receiver operator characteristic) analysis, the cut-off value of TDRS was set at 18 (sensitivity = 0.81; specificity = 0.85). Prediction of severe (grade ⩾ 3) acute swallowing dysfunction was similarly obtained.ConclusionThe TDRS is a useful tool to predict acute swallowing dysfunction induced by chemoradiotherapy for head and neck cancers.