Joanne M Patterson1, Liya Lu2, Laura-Jayne Watson3, Sam Harding4, Andy R Ness5, Steve Thomas6, Andrea Waylen7, Tim Waterboer8, Linda Sharp9. 1. Liverpool Head and Neck Centre, School of Health Science, University of Liverpool, United Kingdom. Electronic address: joanne.patterson@liverpool.ac.uk. 2. Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, United Kingdom. Electronic address: Liya.Lu@newcastle.ac.uk. 3. South Tyneside and Sunderland NHS Foundation Trust, United Kingdom. Electronic address: Laura-Jayne.Watson@chsft.nhs.uk. 4. Bristol Speech and Language Therapy Research Unit, Southmead Hospital North Bristol NHS Hospital Trust, Bristol BS10 5NB, United Kingdom. Electronic address: Samantha.Harding@nbt.nhs.uk. 5. NIHR Bristol Biomedical Research Centre, University Hospitals Bristol, Bristol BS2 8AE, United Kingdom. Electronic address: Andy.Ness@bristol.ac.uk. 6. NIHR Bristol Biomedical Research Centre, University Hospitals Bristol, Bristol BS2 8AE, United Kingdom. Electronic address: Steve.Thomas@bristol.ac.uk. 7. NIHR Bristol Biomedical Research Centre, University Hospitals Bristol, Bristol BS2 8AE, United Kingdom. Electronic address: Andrea.Waylen@bristol.ac.uk. 8. Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Germany. Electronic address: f.T.Waterboer@dkfz-heidelberg.de. 9. Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, United Kingdom. Electronic address: Linda.Sharp@newcastle.ac.uk.
Abstract
OBJECTIVE: To investigate the recovery trajectory and predictors of outcome for swallowing difficulties following head and neck cancer treatment in a large prospective cohort. MATERIALS AND METHODS: Data from 5404 participants of the Head and Neck 5000 study were collected from 2011 to 2014. Patient-reported swallowing was measured using the EORTC HN35, recorded at baseline (pre-treatment) and 4 and 12 months post-baseline. Mixed-effects linear multivariable regression was used to investigate time trends, compare cancer sites, and identify associations between clinical, socio-demographic and lifestyle variables. RESULTS: 2458 participants with non-recurrent oral (29%) oropharyngeal (46%) and laryngeal (25%) cancer were included in the analysis. There was a clinically significant deterioration in scores between baseline and four months for swallowing (11.7 points; 95% CI 10.7-12.8) and trouble with social eating (17.9 points; 95% CI 16.7-19.2), but minimal difference between baseline and 12 months. Predictors of better swallowing and social eating were participants with larynx cancer, early-stage disease, treatment type, age, gender, co-morbidity, socio-economic status, smoking behaviour and cohabitation. CONCLUSION: Swallowing problems persist up to a year after head and neck cancer treatment. These findings identify disease and demographic characteristics for particularly vulnerable groups, supporting the need for holistic interventions to help improve swallowing outcomes. People diagnosed with head and neck cancer at risk of severe eating and drinking problems following treatment can be identified earlier in the pathway, receive more accurate information about early and late post-treatment side-effects, which can inform shared decision-making discussions.
OBJECTIVE: To investigate the recovery trajectory and predictors of outcome for swallowing difficulties following head and neck cancer treatment in a large prospective cohort. MATERIALS AND METHODS: Data from 5404 participants of the Head and Neck 5000 study were collected from 2011 to 2014. Patient-reported swallowing was measured using the EORTC HN35, recorded at baseline (pre-treatment) and 4 and 12 months post-baseline. Mixed-effects linear multivariable regression was used to investigate time trends, compare cancer sites, and identify associations between clinical, socio-demographic and lifestyle variables. RESULTS: 2458 participants with non-recurrent oral (29%) oropharyngeal (46%) and laryngeal (25%) cancer were included in the analysis. There was a clinically significant deterioration in scores between baseline and four months for swallowing (11.7 points; 95% CI 10.7-12.8) and trouble with social eating (17.9 points; 95% CI 16.7-19.2), but minimal difference between baseline and 12 months. Predictors of better swallowing and social eating were participants with larynx cancer, early-stage disease, treatment type, age, gender, co-morbidity, socio-economic status, smoking behaviour and cohabitation. CONCLUSION: Swallowing problems persist up to a year after head and neck cancer treatment. These findings identify disease and demographic characteristics for particularly vulnerable groups, supporting the need for holistic interventions to help improve swallowing outcomes. People diagnosed with head and neck cancer at risk of severe eating and drinking problems following treatment can be identified earlier in the pathway, receive more accurate information about early and late post-treatment side-effects, which can inform shared decision-making discussions.
Authors: Jorine A Vermaire; Cornelis P J Raaijmakers; Evelyn M Monninkhof; C René Leemans; Robert J Baatenburg de Jong; Robert P Takes; Irma M Verdonck-de Leeuw; Femke Jansen; Johannes A Langendijk; Chris H J Terhaard; Caroline M Speksnijder Journal: Support Care Cancer Date: 2022-08-30 Impact factor: 3.359