OBJECTIVES: Assess impact of sequential chemoradiation therapy (SCRT) for advanced head and neck cancer (HNCA) on swallowing, nutrition, and quality of life. STUDY DESIGN: Prospective cohort study of 59 patients undergoing SCRT for advanced head and neck cancer. Follow-up median was 47.5 months. SETTING: Regional Cancer Center. RESULTS: Median time to gastrostomy tube removal was 21 weeks. Eighteen of 23 patients who underwent modified barium swallow demonstrated aspiration; none developed pneumonia. Six of 7 with pharyngoesophageal stricture underwent successful dilatation. Functional Assessment of Cancer Therapy-Head and Neck Scale questionnaires at median 6 months after treatment revealed "somewhat" satisfaction with swallowing. At the time of analysis, 97% have the gastronomy tube removed and take soft/regular diet. CONCLUSION: Early after treatment dysphagia adversely affected weight, modified barium swallow results, and quality of life. Diligent swallow therapy, and dilation as needed, allowed nearly all patients to have their gastronomy tubes removed and return to a soft/regular diet. SIGNIFICANCE: Dysphagia is significant after SCRT but generally slowly recovers 6 to 12 months after SCRT. EBM RATING: C-4.
OBJECTIVES: Assess impact of sequential chemoradiation therapy (SCRT) for advanced head and neck cancer (HNCA) on swallowing, nutrition, and quality of life. STUDY DESIGN: Prospective cohort study of 59 patients undergoing SCRT for advanced head and neck cancer. Follow-up median was 47.5 months. SETTING: Regional Cancer Center. RESULTS: Median time to gastrostomy tube removal was 21 weeks. Eighteen of 23 patients who underwent modified barium swallow demonstrated aspiration; none developed pneumonia. Six of 7 with pharyngoesophageal stricture underwent successful dilatation. Functional Assessment of Cancer Therapy-Head and Neck Scale questionnaires at median 6 months after treatment revealed "somewhat" satisfaction with swallowing. At the time of analysis, 97% have the gastronomy tube removed and take soft/regular diet. CONCLUSION: Early after treatment dysphagia adversely affected weight, modified barium swallow results, and quality of life. Diligent swallow therapy, and dilation as needed, allowed nearly all patients to have their gastronomy tubes removed and return to a soft/regular diet. SIGNIFICANCE: Dysphagia is significant after SCRT but generally slowly recovers 6 to 12 months after SCRT. EBM RATING: C-4.
Authors: Claudia I Chapuy; Donald J Annino; Anna Snavely; Yi Li; Roy B Tishler; Charles M Norris; Robert I Haddad; Laura A Goguen Journal: Otolaryngol Head Neck Surg Date: 2011-09 Impact factor: 3.497
Authors: Kevin A Peng; Edward C Kuan; Lindsey Unger; William C Lorentz; Marilene B Wang; Jennifer L Long Journal: Otolaryngol Head Neck Surg Date: 2015-03-31 Impact factor: 3.497
Authors: Lisette van der Molen; Maya A van Rossum; Lori M Burkhead; Ludi E Smeele; Frans J M Hilgers Journal: Eur Arch Otorhinolaryngol Date: 2008-09-30 Impact factor: 2.503
Authors: Miriam N Lango; Brian Egleston; Kevin Ende; Steven Feigenberg; David J D'Ambrosio; Roger B Cohen; Sidrah Ahmad; Nicos Nicolaou; John A Ridge Journal: Head Neck Date: 2010-03 Impact factor: 3.147
Authors: Lisette van der Molen; Maya A van Rossum; Annemieke H Ackerstaff; Ludi E Smeele; Coen R N Rasch; Frans J M Hilgers Journal: BMC Ear Nose Throat Disord Date: 2009-11-15