J M Patterson1, E McColl2, P N Carding3, J A Wilson2. 1. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK; Speech & Language Therapy Dept., Sunderland Royal Hospital, Sunderland, UK. Electronic address: joanne.patterson@ncl.ac.uk. 2. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK. 3. School of Allied and Public Health, Australian Catholic University, Brisbane, Australia.
Abstract
OBJECTIVE: The objective of this prospective study is to report on long-term swallowing outcomes in a group of head and neck cancer patients following (chemo) radiotherapy treatment, assess for changes over time and identify any predictor variables of outcome. MATERIALS AND METHODS: 42 survivors were assessed on four swallowing measures and followed up from pre-treatment to six years post 3D (chemo) radiotherapy. Measures included a swallowing specific QOL questionnaire, penetration-aspiration scale, dietary restrictions and a timed water swallow test. RESULTS: At six years, 71% reported swallowing difficulties on the questionnaire. One fifth of patients had aspiration, with a raised risk of chest infection. Seven percent required a laryngectomy for a dysfunctional larynx. Despite this, half the group reported having a normal diet. There was variation in the pattern of change between one and six years. A significant deterioration was only observed in the timed water swallow test (p < 0.0001). Larger radiotherapy volume predicted this outcome. None of the variables tested predicted outcome for the other three swallow measures. CONCLUSION: Patients continue to report swallowing difficulties at six years, with a proportion having persistent aspiration. Further work on identifying the risk factors associated with aspiration tolerance, aspiration pneumonia, prevention and management is warranted. Long-term dysphagia remains a significant and serious concern following (chemo) radiotherapy for HNC and swallowing outcomes should continue to be monitored over time.
OBJECTIVE: The objective of this prospective study is to report on long-term swallowing outcomes in a group of head and neck cancer patients following (chemo) radiotherapy treatment, assess for changes over time and identify any predictor variables of outcome. MATERIALS AND METHODS: 42 survivors were assessed on four swallowing measures and followed up from pre-treatment to six years post 3D (chemo) radiotherapy. Measures included a swallowing specific QOL questionnaire, penetration-aspiration scale, dietary restrictions and a timed water swallow test. RESULTS: At six years, 71% reported swallowing difficulties on the questionnaire. One fifth of patients had aspiration, with a raised risk of chest infection. Seven percent required a laryngectomy for a dysfunctional larynx. Despite this, half the group reported having a normal diet. There was variation in the pattern of change between one and six years. A significant deterioration was only observed in the timed water swallow test (p < 0.0001). Larger radiotherapy volume predicted this outcome. None of the variables tested predicted outcome for the other three swallow measures. CONCLUSION: Patients continue to report swallowing difficulties at six years, with a proportion having persistent aspiration. Further work on identifying the risk factors associated with aspiration tolerance, aspiration pneumonia, prevention and management is warranted. Long-term dysphagia remains a significant and serious concern following (chemo) radiotherapy for HNC and swallowing outcomes should continue to be monitored over time.
Authors: Janice L Farlow; Andrew C Birkeland; Anna Hardenbergh; Teresa Lyden; J Chad Brenner; Andrew G Shuman; Steven B Chinn; Chaz L Stucken; Kelly M Malloy; Jeffrey S Moyer; Keith A Casper; Mark E P Prince; Carol R Bradford; Gregory T Wolf; Douglas B Chepeha; Andrew J Rosko; Matthew E Spector Journal: Eur Arch Otorhinolaryngol Date: 2020-01-27 Impact factor: 2.503
Authors: Marianne Boll Kristensen; Irene Wessel; Anne Marie Beck; Karin B Dieperink; Tina Broby Mikkelsen; Jens-Jakob Kjer Møller; Ann-Dorthe Zwisler Journal: Nutrients Date: 2020-07-17 Impact factor: 5.717