M M Szczesniak1, J Maclean2, T Zhang3, P H Graham4, I J Cook3. 1. Department of Gastroenterology and Hepatology, St George Hospital, Sydney, NSW, Australia; St George Clinical School, University of New South Wales, Sydney, NSW, Australia. Electronic address: m.szczesniak@unsw.edu.au. 2. Speech Pathology Department, St George Hospital, Sydney, NSW, Australia. 3. Department of Gastroenterology and Hepatology, St George Hospital, Sydney, NSW, Australia; St George Clinical School, University of New South Wales, Sydney, NSW, Australia. 4. Department of Radiation Oncology, Cancer Care Centre, St George Hospital, Sydney, NSW, Australia.
Abstract
AIMS: Dysphagia is a well-recognised acute complication after radiotherapy. However, knowledge about the long-term prevalence and effect remains limited. The aims of this study were to determine the prevalence, severity, morbidity, time course and reporting patterns of dysphagia symptoms after head and neck radiotherapy. MATERIALS AND METHODS: An observational cross-sectional study was conducted in a large consecutive series of head and neck cancer patients. All patients in the St George Hospital Cancer Care database who had received head and neck radiotherapy with curative intent 0.5-8 years previously and recorded as being alive were surveyed using the Sydney Swallow Questionnaire (SSQ). Case notes were reviewed to determine the level of awareness of swallowing dysfunction in all patients, as well as the causes of mortality in the 83 deceased patients. RESULTS: The mean follow-up at the time of survey was 3 years after radiotherapy (range 0.5-8 years). Of the 116 patients surveyed by questionnaire, the response rate was 72% (83). Impaired swallowing (SSQ score > 234) was reported by 59% of patients. Dysphagia severity was not predicted by tumour site or stage, nor by the time since therapy, age, gender or adjuvant chemotherapy. Review of the hospital medical records and cancer database revealed that cancer accounted for 55% of deaths and aspiration pneumonia was responsible for 19% of non-cancer-related deaths. Of those with abnormal SSQ scores, only 47% reported dysphagia during follow-up clinic visits. CONCLUSIONS: Persistent dysphagia is a prevalent, under-recognised and under-reported long-term complication of head and neck radiotherapy which currently cannot be predicted on the basis of patient, tumour or treatment characteristics. Aspiration pneumonia is an important contributor to non-cancer-related mortality in these patients. These data highlight the need for closer monitoring of swallow dysfunction and its sequelae in this population.
AIMS: Dysphagia is a well-recognised acute complication after radiotherapy. However, knowledge about the long-term prevalence and effect remains limited. The aims of this study were to determine the prevalence, severity, morbidity, time course and reporting patterns of dysphagia symptoms after head and neck radiotherapy. MATERIALS AND METHODS: An observational cross-sectional study was conducted in a large consecutive series of head and neck cancerpatients. All patients in the St George Hospital Cancer Care database who had received head and neck radiotherapy with curative intent 0.5-8 years previously and recorded as being alive were surveyed using the Sydney Swallow Questionnaire (SSQ). Case notes were reviewed to determine the level of awareness of swallowing dysfunction in all patients, as well as the causes of mortality in the 83 deceased patients. RESULTS: The mean follow-up at the time of survey was 3 years after radiotherapy (range 0.5-8 years). Of the 116 patients surveyed by questionnaire, the response rate was 72% (83). Impaired swallowing (SSQ score > 234) was reported by 59% of patients. Dysphagia severity was not predicted by tumour site or stage, nor by the time since therapy, age, gender or adjuvant chemotherapy. Review of the hospital medical records and cancer database revealed that cancer accounted for 55% of deaths and aspiration pneumonia was responsible for 19% of non-cancer-related deaths. Of those with abnormal SSQ scores, only 47% reported dysphagia during follow-up clinic visits. CONCLUSIONS: Persistent dysphagia is a prevalent, under-recognised and under-reported long-term complication of head and neck radiotherapy which currently cannot be predicted on the basis of patient, tumour or treatment characteristics. Aspiration pneumonia is an important contributor to non-cancer-related mortality in these patients. These data highlight the need for closer monitoring of swallow dysfunction and its sequelae in this population.
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Authors: Adam R Burr; Paul M Harari; Alyx M Haasl; Aaron M Wieland; Justine Y Bruce; Randall J Kimple; Gregory K Hartig; Timothy M McCulloch; Matthew E Witek Journal: Head Neck Date: 2020-02-14 Impact factor: 3.147
Authors: Leen Van den Steen; Olivier Vanderveken; Jan Vanderwegen; Dirk Van Gestel; Jean-François Daisne; Johan Allouche; Laurence Delacroix; Diane Van Rompaey; Sylvie Beauvois; Sophie Cvilic; Steven Mariën; Gauthier Desuter; Jan Baptist Vermorken; Danielle Van den Weyngaert; Pol Specenier; Carl Van Laer; Marc Peeters; Paul Van de Heyning; Gilbert Chantrain; Georges Lawson; Cathy Lazarus; Marc De Bodt; Gwen Van Nuffelen Journal: Support Care Cancer Date: 2017-06-02 Impact factor: 3.603
Authors: D Stone; H Bogaardt; S D Linnstaedt; B Martin-Harris; A C Smith; D M Walton; E Ward; J M Elliott Journal: Dysphagia Date: 2019-08-03 Impact factor: 3.438