Important Role of Pharyngeal Constrictors in Carcinoma of Head and Neck Radiotherapy: Dose Assessment

Preeti Chauhan; Rishi Rana

doi:10.36948/ijfmr.2026.v08i02.71659

Important Role of Pharyngeal Constrictors in Carcinoma of Head and Neck Radiotherapy: Dose Assessment

Author(s)	Dr. Preeti Chauhan, Dr. Rishi Rana
Country	India
Abstract	ABSTRACT Introduction: Late-onset impaired swallowing is a frequent clinically significant outcome of irradiation for head and neck malignancies. Accumulating evidence indicates that radiation exposure of the pharyngeal constrictor musculature contributes substantially to post-treatment dysphagia. Objective: This study evaluated the incidence of late dysphagia and explored associations between dosimetric parameters of pharyngeal constrictor muscles and impaired swallowing in patients receiving definitive irradiation. MATERIAL AND METHODS: In this cohort study, 50 patients were included with oropharyngeal, hypopharyngeal, or laryngeal carcinoma (any T, any N, M0) treated between December 2020 and April 2022. All patients underwent CT-based planning and were treated with intensity-modulated radiotherapy (IMRT) with or without concurrent chemotherapy. Pharyngeal constrictors were delineated as organs at risk. Swallowing function was assessed using the EORTC QLQ-H&N35 questionnaire and graded according to RTOG criteria. Dosimetric parameters correleation was done with impaired swallowing grades at 6 months following irradiation completion. Results: 23 patients were evaluable at 6 months. Grade I, II, and III dysphagia were observed in 60.87%, 30.43%, and 8.7% of patients, respectively. Increasing dysphagia severity demonstrated a consistent trend with higher maximum dose and high-dose volume exposure (V65) to the superior and middle pharyngeal constrictor muscles. Mean and Dmax of SPCM increased from 68.46 Gy in Grade I to 69.21 Gy in Grade III dysphagia, while V65 increased from 28.58% to 63.38%. Similar dose–volume escalation was noted for the MPCM. These differences did not reach statistical significance. Conclusion: Higher dose and volume exposure of the superior and middle pharyngeal constrictor muscles shows direct association with worsening of impaired swallowing. IMRT planning strategies that prioritize sparing of these structures may reduce long-term swallowing morbidity. Larger prospective studies with extended follow-up are needed to define robust dose constraints.
Keywords	Carcinoma of head and neck; radiation-induced impaired swallowing; pharyngeal constrictor muscles; intensity-modulated radiotherapy; dose–volume parameters; late toxicity.
Published In	Volume 8, Issue 2, March-April 2026
Published On	2026-03-16
DOI	https://doi.org/10.36948/ijfmr.2026.v08i02.71659

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Important Role of Pharyngeal Constrictors in Carcinoma of Head and Neck Radiotherapy: Dose Assessment

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