Total Dysphagia Risk Score (TDRS) of Langendijk et al

Description

Langendijk et al developed the Total Dysphagia Risk Score (TDRS) to identify a patient with head and neck cancer who is likely to experience swallowing dysfunction following curative radiotherapy. This can help to identify a patient who may require more aggressive management. The authors are from VU University Medical Center Amsterdam and University Medical Center Groningen in The Netherlands.

Patient selection: head and neck cancer treated with radiotherapy

Outcome: RTOG swallowing dysfunction at 6 months and NTCP (normal tissue complication probability)

Parameters:

(1) T classification

(2) neck irradiation

(3) weight loss in percent

(4) primary tumor site

(5) radiotherapy

(6) concomitant chemotherapy (usually cisplatin based)

Parameter	Finding	Points
T classification	T1 to T2	0
	T3 or T4	4
neck irradiation	primary with or without ipsilateral neck	0
	bilateral	9
weight loss	none or weight gain	0
	1 to 10%	5
	> 10%	7
primary tumor site	oropharynx	7
	nasopharynx	9
	larynx or other	0
radiotherapy	conventional	0
	accelerated	6
concomitant chemotherapy	no	0
	yes	5

where:

• The description of the score has points assigned for treatment modality. The handling of chemotherapy is ambiguous. Separating it out is based on the maximum risk score of 40 shown in Figure 1.

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 40

• The higher the score the greater the risk for swallowing dysfunction.

Total Score	Risk RTOG Grade 2-4 at 6 months	NTCP
0 to 9	low	<= 10%
10 to 18	intermediate	10.1 to 30%
19 to 40	high	> 30%

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Total Dysphagia Risk Score (TDRS) of Langendijk et al

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