OBJECTIVE: To describe swallowing physiology and functional outcomes at select intervals after definitive radiotherapy for laryngeal carcinoma. We also examined associations among patient, tumor, and treatment characteristics and swallowing outcomes. DESIGN: Retrospective review. SETTING: The University of Texas M. D. Anderson Cancer Center, Houston. PATIENTS: This study cohort included 40 patients who underwent definitive radiotherapy for laryngeal carcinoma (from February 2001 to June 2004). MAIN OUTCOME MEASURES: Modified barium swallow (MBS) studies were performed for 32 patients at 3 test intervals following irradiation: less than 6 months, 6 to 11 months, and 12 or more months. We recorded the presence or absence of aspiration (sensate or silent), 5 pharyngeal phase disorders, and 2 structural abnormalities. We also recorded pretreatment dysphagia complaints, feeding tube dependency, T classification, disease site, mucositis grade, and radiotherapy schedule with or without chemotherapy. RESULTS: Eighty-four percent of patients (27 of 32) referred for MBS studies after undergoing radiotherapy aspirated; 44% (12 of 27) did so silently. Silent aspiration was more prevalent during MBS studies conducted 1 or more years after radiotherapy. Pharyngeal phase disorders were observed more frequently than structural abnormalities (P < .01). Most patients required a feeding tube (78% [31 of 40]); however, 52% of the tubes (16) were eventually removed. We found no significant association between the occurrence of aspiration and disease site, T classification, treatment regimen, or pretreatment variables (P > .05). Pretreatment and posttreatment levels of feeding tube dependency were significantly associated (P = .03). Patient-reported dysphagia before treatment did not predict posttreatment swallowing outcomes (P > .05). CONCLUSIONS: Dysphagia is a common outcome after laryngeal preservation with radiotherapy. Contrary to expectations, few parameters that we measured were significantly associated with swallowing outcomes in our study.
OBJECTIVE: To describe swallowing physiology and functional outcomes at select intervals after definitive radiotherapy for laryngeal carcinoma. We also examined associations among patient, tumor, and treatment characteristics and swallowing outcomes. DESIGN: Retrospective review. SETTING: The University of Texas M. D. Anderson Cancer Center, Houston. PATIENTS: This study cohort included 40 patients who underwent definitive radiotherapy for laryngeal carcinoma (from February 2001 to June 2004). MAIN OUTCOME MEASURES: Modified barium swallow (MBS) studies were performed for 32 patients at 3 test intervals following irradiation: less than 6 months, 6 to 11 months, and 12 or more months. We recorded the presence or absence of aspiration (sensate or silent), 5 pharyngeal phase disorders, and 2 structural abnormalities. We also recorded pretreatment dysphagia complaints, feeding tube dependency, T classification, disease site, mucositis grade, and radiotherapy schedule with or without chemotherapy. RESULTS: Eighty-four percent of patients (27 of 32) referred for MBS studies after undergoing radiotherapy aspirated; 44% (12 of 27) did so silently. Silent aspiration was more prevalent during MBS studies conducted 1 or more years after radiotherapy. Pharyngeal phase disorders were observed more frequently than structural abnormalities (P < .01). Most patients required a feeding tube (78% [31 of 40]); however, 52% of the tubes (16) were eventually removed. We found no significant association between the occurrence of aspiration and disease site, T classification, treatment regimen, or pretreatment variables (P > .05). Pretreatment and posttreatment levels of feeding tube dependency were significantly associated (P = .03). Patient-reported dysphagia before treatment did not predict posttreatment swallowing outcomes (P > .05). CONCLUSIONS:Dysphagia is a common outcome after laryngeal preservation with radiotherapy. Contrary to expectations, few parameters that we measured were significantly associated with swallowing outcomes in our study.
Authors: Primož Strojan; Katherine A Hutcheson; Avraham Eisbruch; Jonathan J Beitler; Johannes A Langendijk; Anne W M Lee; June Corry; William M Mendenhall; Robert Smee; Alessandra Rinaldo; Alfio Ferlito Journal: Cancer Treat Rev Date: 2017-07-18 Impact factor: 12.111
Authors: Ryan P Goepfert; Jan S Lewin; Martha P Barrow; Carla L Warneke; Clifton D Fuller; Stephen Y Lai; Randal S Weber; Katherine A Hutcheson Journal: Dysphagia Date: 2017-08-23 Impact factor: 3.438
Authors: Barbara Roa Pauloski; Alfred W Rademaker; Jerilyn A Logemann; Donna Lundy; Michelle Bernstein; Carrie McBreen; Daphne Santa; Angela Campanelli; Lisa Kelchner; Bernice Klaben; Muveddet Discekici-Harris Journal: Head Neck Date: 2010-08-24 Impact factor: 3.147
Authors: Katherine A Hutcheson; Clare P Alvarez; Denise A Barringer; Michael E Kupferman; Peter R Lapine; Jan S Lewin Journal: Otolaryngol Head Neck Surg Date: 2012-01-10 Impact factor: 3.497
Authors: Diane Wenhua Chen; Jan S Lewin; Li Xu; Stephen Y Lai; G Brandon Gunn; Clifton David Fuller; Abdallah S R Mohamed; Aasheesh Kanwar; Erich M Sturgis; Katherine A Hutcheson Journal: Otolaryngol Head Neck Surg Date: 2016-10-03 Impact factor: 3.497
Authors: F Christopher Holsinger; Merrill S Kies; Eduardo M Diaz; Ann M Gillenwater; Jan S Lewin; Lawrence E Ginsberg; Bonnie S Glisson; Adam S Garden; Nebil Ark; Heather Y Lin; J Jack Lee; Adel K El-Naggar; Waun Ki Hong; Dong M Shin; Fadlo R Khuri Journal: J Clin Oncol Date: 2009-03-16 Impact factor: 44.544