The prevalence of gastroesophageal reflux disease and laryngopharyngeal reflux in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma

Head Neck. 2024 Jul;46(7):1637-1659. doi: 10.1002/hed.27645. Epub 2024 Jan 18.

Abstract

Background: The prevalence of gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) in post-irradiated patients with nasopharyngeal carcinoma (NPC) is unknown.

Materials and methods: In a cross-sectional study, 31 NPC and 12 control patients completed questionnaires for GERD/LPR before esophageal manometry and 24-h pH monitoring. The DeMeester score and reflux finding score (RFS) were used to define GERD and LPR, respectively. Risk factors were identified.

Results: 51.6% of NPC and 8.3% of control patients, and 77.4% of NPC and 33% of control patients, were GERD-positive and LPR-positive, respectively. The GERD/LPR questionnaire failed to identify either condition in patients with NPC. No parameter differences in esophageal manometry or pneumonia incidence were noted between GERD/LPR-positive and GERD/LPR-negative patients. Post radiotherapy duration, high BMI, lack of chemotherapy, and dysphagia were positive risk factors for GERD/LPR.

Conclusions: A high prevalence of GERD/LPR in patients with post-irradiated NPC exists, but reflux symptoms are inadequate for diagnosis.

Keywords: dysphagia; gastroesophageal; head and neck; laryngopharyngeal; nasopharyngeal cancer; radiotherapy; reflux.

MeSH terms

  • Adult
  • Aged
  • Carcinoma / radiotherapy
  • Case-Control Studies
  • Cross-Sectional Studies
  • Deglutition Disorders* / epidemiology
  • Deglutition Disorders* / etiology
  • Esophageal pH Monitoring
  • Female
  • Gastroesophageal Reflux* / complications
  • Gastroesophageal Reflux* / epidemiology
  • Gastroesophageal Reflux* / etiology
  • Humans
  • Laryngopharyngeal Reflux* / epidemiology
  • Laryngopharyngeal Reflux* / etiology
  • Male
  • Manometry*
  • Middle Aged
  • Nasopharyngeal Carcinoma* / complications
  • Nasopharyngeal Carcinoma* / radiotherapy
  • Nasopharyngeal Neoplasms* / complications
  • Nasopharyngeal Neoplasms* / radiotherapy
  • Prevalence
  • Risk Factors
  • Surveys and Questionnaires