Risk factors for late dysphagia after (chemo)radiotherapy for head and neck cancer: A systematic methodological review.

BACKGROUND The purpose of this systematic review was to identify the risk factors for late dysphagia in patients with head and neck cancer after (chemo)radiotherapy. METHODS The review was performed using search strategies, including PubMed, the Cochrane Library, and Embase databases. The effects of studies were combined with the study quality score using a best-evidence synthesis model. RESULTS Twenty observational studies were evaluated. According to the best-evidence synthesis criteria, there were 2 strong-evidence risk factors for late dysphagia, including the use of chemoradiotherapy (CRT) and the presence of hypopharyngeal carcinoma. We also identified 8 moderate-evidence, 17 limited-evidence, and 1 conflicting-evidence risk factors. CONCLUSION Although there is no conclusive evidence for dysphagia in patients with head and neck cancer after (chemo)radiotherapy, these data provide evidence to guide clinicians in patients who will have late dysphagia and to choose an optimal prophylactic strategy.