Jacqui Frowen1, Allison Drosdowsky2, Alison Perry3, June Corry4,5. 1. Speech Pathology Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia. 2. Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia. 3. Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland. 4. Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia. 5. University of Melbourne, Grattan St, Parkville, Victoria, Australia.
Abstract
BACKGROUND: This prospective study evaluated long-term swallowing outcomes and associated risk factors 5 years postchemoradiotherapy for head and neck cancer. METHODS: Following an earlier study of 69 patients, 39 patients had patient-reported activity and quality of life (QOL) data collected. Twenty-one patients also underwent a videofluoroscopy swallowing study (VFSS). RESULTS: Between 6 months and 5 years posttreatment, patient-reported activity for solid foods significantly improved (p < .001), returning to pretreatment levels for 74% of patients. On VFSS, swallowing function for semisolids declined, with 5 patients demonstrating a clinically significant deterioration. Factors that predicted poorer long-term swallowing were the same as at 6 months, with the addition of older age and disease stage. CONCLUSION: Although long-term patient-reported activity improves and swallowing-related QOL is high, up to 24% of patients may demonstrate a clinically significant deterioration in swallowing function at 5 years posttreatment. This divergence suggests a degree of adaptation that patients develop, which warrants further investigation.
BACKGROUND: This prospective study evaluated long-term swallowing outcomes and associated risk factors 5 years postchemoradiotherapy for head and neck cancer. METHODS: Following an earlier study of 69 patients, 39 patients had patient-reported activity and quality of life (QOL) data collected. Twenty-one patients also underwent a videofluoroscopy swallowing study (VFSS). RESULTS: Between 6 months and 5 years posttreatment, patient-reported activity for solid foods significantly improved (p < .001), returning to pretreatment levels for 74% of patients. On VFSS, swallowing function for semisolids declined, with 5 patients demonstrating a clinically significant deterioration. Factors that predicted poorer long-term swallowing were the same as at 6 months, with the addition of older age and disease stage. CONCLUSION: Although long-term patient-reported activity improves and swallowing-related QOL is high, up to 24% of patients may demonstrate a clinically significant deterioration in swallowing function at 5 years posttreatment. This divergence suggests a degree of adaptation that patients develop, which warrants further investigation.
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