Dysphagia after sequential chemoradiation therapy for advanced head and neck cancer

  • Laura A. Goguen
  • , Marshall R. Posner
  • , Charles M. Norris
  • , Roy B. Tishler
  • , Lori J. Wirth
  • , Donald J. Annino
  • , Adele Gagne
  • , Christopher A. Sullivan
  • , Daniel E. Sammartino
  • , Robert I. Haddad

Research output: Contribution to journalArticlepeer-review

99 Scopus citations

Abstract

Objectives: Assess impact of sequential chemoradiation therapy (SCRT) for advanced head and neck cancer (HNCA) on swallowing, nutrition, and quality of life. Study design: Prospective cohort study of 59 patients undergoing SCRT for advanced head and neck cancer. Follow-up median was 47.5 months. Setting: Regional Cancer Center. Results: Median time to gastrostomy tube removal was 21 weeks. Eighteen of 23 patients who underwent modified barium swallow demonstrated aspiration; none developed pneumonia. Six of 7 with pharyngoesophageal stricture underwent successful dilatation. Functional Assessment of Cancer Therapy-Head and Neck Scale questionnaires at median 6 months after treatment revealed "somewhat" satisfaction with swallowing. At the time of analysis, 97% have the gastronomy tube removed and take soft/regular diet. Conclusion: Early after treatment dysphagia adversely affected weight, modified barium swallow results, and quality of life. Diligent swallow therapy, and dilation as needed, allowed nearly all patients to have their gastronomy tubes removed and return to a soft/regular diet. Significance: Dysphagia is significant after SCRT but generally slowly recovers 6 to 12 months after SCRT. EBM rating: C-4.

Original languageEnglish
Pages (from-to)916-922
Number of pages7
JournalOtolaryngology - Head and Neck Surgery
Volume134
Issue number6
DOIs
StatePublished - Jun 2006
Externally publishedYes

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