Dysphagia in treated nasopharyngeal cancer.
OBJECTIVE
To investigate the prevalence of long-term dysphagia in patients treated for nasopharyngeal carcinoma (NPC) by radiotherapy. Study Design Questionnaire-based assessment, clinical examination, and videofluoroscopic assessment of 50 patients, ages 26 to 75 years (average, 49 years), treated for NPC 12 to 119 months (average, 56 months) previously with no evidence of disease recurrence.


METHODS
Administered questionnaire assessment of patients eating and swallowing. Clinical examination by a single experienced clinician. Videofluoroscopy was used to record swallowing of solid, paste, and liquid bolus. Pharyngeal transit time (PTT) was recorded, and the video recordings were assessed by two experienced observers for abnormalities.


RESULTS
Fifty patients completed the questionnaire and were examined. Seventy-six percent reported dysphagia, 97% had xerostomia, and 78% had no gag reflex. Forty-nine patients underwent videofluoroscopy. Abnormal pharyngeal contraction was observed on videofluoroscopy in 93% of the subjects. Silent aspiration was observed in 22% of the patients. PTT was prolonged from a normal of 1 second to 1.9 seconds for solid, 1.7 seconds for paste, and 1.3 seconds for liquid consistencies.


CONCLUSIONS
Subjective and objective swallowing abnormalities are common after radiotherapy for NPC. The implications of this finding and possible causes are discussed.
Hughes
P J
PJ
Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin.
Scott
P M
PM
Kew
J
J
Cheung
D M
DM
Leung
S F
SF
Ahuja
A T
AT
van Hasselt
C A
CA
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000532:radiotherapy*; D015897:Comorbidity; D003680:Deglutition Disorders / Q000453:epidemiology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000532:radiotherapy*; D010358:Patient Participation; D011379:Prognosis; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011897:Random Allocation; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014741:Video Recording