Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

Abstract Background Acute and late toxicity after intensity‐modulated radiotherapy (IMRT) for head and neck cancer (HNC) impacts on patient quality of life; yet, very late toxicity data remain scarce. This study assessed dysphagia, xerostomia, and neck fibrosis 3‐8 years after IMRT. Methods A retrospective analysis using generalized estimated equations was performed on 60 patients with HNC treated with fractionated IMRT between 2000 and 2015 who had a follow‐up ≥8 years. Toxicity was scored using LENT‐SOMA scales. Results A trend towards a nonlinear global time effect ( P = .05) was noted for dysphagia with a decrease during the 5 years post‐treatment and an increase thereafter. A significant decrease in xerostomia ( P = .001) and an increase in neck fibrosis ( P = .04) was observed until 8 years. Conclusions Dysphagia, xerostomia, and neck fibrosis do not appear stable over time and remain highly prevalent in the very late follow‐up. Our findings support the need for prospective trials investigating very late toxicity in patients with HNC.