KEY POINTS
- This retrospective study included 52 patients with oral cavity squamous cell carcinoma treated with definitive or postoperative volumetric modulated arc therapy between 2019 and 2023. All received prophylactic feeding tubes.
- Late dysphagia was defined as feeding-tube dependence exceeding the cohort’s 75th percentile of 442.5 days and occurred in 13 patients (25%).
- Patients with prolonged feeding-tube dependence had smaller median base-of-tongue volumes than those without it: 16.1 versus 19.5 cm³ (p = 0.02). A volume above 19.12 cm³ was associated with lower risk.
- No base-of-tongue dose-volume parameter was significantly associated with the endpoint. A median-dose threshold of 52.2 Gy produced only a non-significant signal (p = 0.21).
- A model combining base-of-tongue volume and median dose achieved an area under the curve of 0.74 (95% confidence interval, 0.61–0.87).
CLINICAL TAKEAWAY
Base-of-tongue volume may represent an anatomical vulnerability marker for impaired swallowing recovery, but this study does not establish a usable planning constraint. The small cohort, institution-specific feeding-tube policy, short follow-up and non-validated endpoint make the findings hypothesis-generating.