Swallowing beyond six years post (chemo)radiotherapy for head and neck cancer: A cohort study

Journal article


Patterson, J. M., McColl, E., Carding, P. N. and Wilson, J. A.. (2018). Swallowing beyond six years post (chemo)radiotherapy for head and neck cancer: A cohort study. Oral Oncology. 83, pp. 53 - 58. https://doi.org/10.1016/j.oraloncology.2018.06.003
AuthorsPatterson, J. M., McColl, E., Carding, P. N. and Wilson, J. A.
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.

Keywordsdysphagia; head and neck cancer; radiotherapy; chemoradiotherapy; swallow outcomes; swallow assessment; late effects
Year2018
JournalOral Oncology
Journal citation83, pp. 53 - 58
PublisherElsevier
ISSN1368-8375
Digital Object Identifier (DOI)https://doi.org/10.1016/j.oraloncology.2018.06.003
Scopus EID2-s2.0-85048525373
Page range53 - 58
Research GroupSchool of Allied Health
Publisher's version
File Access Level
Controlled
Place of publicationUnited Kingdom
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