James O'Hara1, Benjamin Cosway2, Colin Muirhead3, Nicola Leonard4, Diane Goff4, Joanne Patterson4,5. 1. Department of Otolaryngology-Head and Neck Surgery, Sunderland Royal Hospital and Institute of Health and Society, Newcastle University, United Kingdom. 2. Academic Foundation, Newcastle upon Tyne NHS Foundation Trust and Associate Clinical Research, Newcastle University, United Kingdom. 3. Medical Statistics, Institute of Health and Society, Newcastle University, United Kingdom. 4. Department of Speech and Language Therapy, Sunderland Royal Hospital, United Kingdom. 5. Institute of Health and Society, Newcastle University, United Kingdom.
Abstract
BACKGROUND: Observational data suggests transoral surgery may offer benefit in swallowing over chemoradiotherapy. METHODS: In this preliminary, non-randomized study, patients with stage III and IVA oropharyngeal carcinoma treated with transoral laser microsurgery (TLM) were assessed pretreatment and 3 months after treatment using the MD Anderson Dysphagia Inventory (MDADI), the Performance Status Scale (PSS), and a timed Water Swallow Test (WST). Comparisons were made with a historical chemoradiotherapy (CRT) cohort. RESULTS: Based on patients with measurements at both times, the decrease in score between baseline and 3 months was greater for CRT patients (n = 26-28) than for TLM (n = 20-21) patients for each of MDADI, PSS, and WST. A repeated measures analysis that looked at all 3 scores simultaneously and allowed for missing values gave mostly similar results (except for MDADI). CONCLUSION: TLM was associated with good early swallowing outcomes at 3 months and may offer a benefit over CRT. The results should be viewed as preliminary data, providing useful reference for any proposed controlled trial.
BACKGROUND: Observational data suggests transoral surgery may offer benefit in swallowing over chemoradiotherapy. METHODS: In this preliminary, non-randomized study, patients with stage III and IVA oropharyngeal carcinoma treated with transoral laser microsurgery (TLM) were assessed pretreatment and 3 months after treatment using the MD Anderson Dysphagia Inventory (MDADI), the Performance Status Scale (PSS), and a timed Water Swallow Test (WST). Comparisons were made with a historical chemoradiotherapy (CRT) cohort. RESULTS: Based on patients with measurements at both times, the decrease in score between baseline and 3 months was greater for CRT patients (n = 26-28) than for TLM (n = 20-21) patients for each of MDADI, PSS, and WST. A repeated measures analysis that looked at all 3 scores simultaneously and allowed for missing values gave mostly similar results (except for MDADI). CONCLUSION: TLM was associated with good early swallowing outcomes at 3 months and may offer a benefit over CRT. The results should be viewed as preliminary data, providing useful reference for any proposed controlled trial.
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