Cathy L Lazarus1. 1. NYU Voice Center, Department of Otolaryngology, New York University School of Medicine, Bellevue Hospital Center, 550 First Avenue NBV5E5, New York, NY 10016, USA. cathy.lazarus@nyumc.org
Abstract
PURPOSE OF REVIEW: Chemotherapy has been found to result in comparable survival rates to surgery for head and neck cancer. However, toxicity can often be worse after chemoradiotherapy, with impairment in voice, swallowing, nutrition, and quality of life. Investigators are attempting to modify radiotherapy treatment regimens to spare organs that have an impact on swallowing. This review will highlight voice and swallowing impairment seen after chemoradiotherapy, as well as treatment for voice and swallowing disorders in this population. Results of newer radiotherapy regimens will also be highlighted. RECENT FINDINGS: Specific oropharyngeal swallowing motility disorders after chemoradiotherapy have been identified. Damage to specific structures has been correlated with specific pharyngeal phase swallow impairment. Swallowing function and quality of life have been examined over time, with improvement seen in both. Preventive/prophylactic swallow exercise programs have been encouraging. Chemoradiotherapy effects on voice have been identified in terms of acoustic, aerodynamic, and patient and clinician-rated perception of function. Improvement in voice has also been observed over time after chemoradiotherapy. Voice therapy has been found to have a positive impact on voice and perceptual measures in this population. SUMMARY: Current studies show some improvement in swallow function after swallow and voice therapy in patients treated with chemoradiotherapy. Further, there is a suggestion of improved swallow function with sparing of organs with specific radiotherapy protocols. Future research needs to focus on specific voice and swallow treatment regimens in the head and neck cancer patient treated with chemoradiotherapy, specifically, timing, frequency, duration, and specific treatment types.
PURPOSE OF REVIEW: Chemotherapy has been found to result in comparable survival rates to surgery for head and neck cancer. However, toxicity can often be worse after chemoradiotherapy, with impairment in voice, swallowing, nutrition, and quality of life. Investigators are attempting to modify radiotherapy treatment regimens to spare organs that have an impact on swallowing. This review will highlight voice and swallowing impairment seen after chemoradiotherapy, as well as treatment for voice and swallowing disorders in this population. Results of newer radiotherapy regimens will also be highlighted. RECENT FINDINGS: Specific oropharyngeal swallowing motility disorders after chemoradiotherapy have been identified. Damage to specific structures has been correlated with specific pharyngeal phase swallow impairment. Swallowing function and quality of life have been examined over time, with improvement seen in both. Preventive/prophylactic swallow exercise programs have been encouraging. Chemoradiotherapy effects on voice have been identified in terms of acoustic, aerodynamic, and patient and clinician-rated perception of function. Improvement in voice has also been observed over time after chemoradiotherapy. Voice therapy has been found to have a positive impact on voice and perceptual measures in this population. SUMMARY: Current studies show some improvement in swallow function after swallow and voice therapy in patients treated with chemoradiotherapy. Further, there is a suggestion of improved swallow function with sparing of organs with specific radiotherapy protocols. Future research needs to focus on specific voice and swallow treatment regimens in the head and neck cancerpatient treated with chemoradiotherapy, specifically, timing, frequency, duration, and specific treatment types.
Authors: Lisa A Newman; K Thomas Robbins; Jeri A Logemann; Alfred W Rademaker; Cathy L Lazarus; Annette Hamner; Stephanie Tusant; Cheng Fang Huang Journal: Head Neck Date: 2002-01 Impact factor: 3.147
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Authors: Cathy Lazarus; Jeri A Logemann; Chi Wook Song; Alfred W Rademaker; Peter J Kahrilas Journal: Folia Phoniatr Logop Date: 2002 Jul-Aug Impact factor: 0.849
Authors: C L Lazarus; J A Logemann; B R Pauloski; A W Rademaker; C R Larson; B B Mittal; M Pierce Journal: J Speech Lang Hear Res Date: 2000-08 Impact factor: 2.297
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