Swallow function in patients before and after intra-arterial chemoradiation.
OBJECTIVE
To prospectively evaluate swallow function in patients with advanced head and neck cancer before and after completion of intra-arterial chemoradiation therapy and planned neck dissection.


METHODS
Prospective nonrandomized study. METHODS Swallow function was evaluated in 11 patients with resectable T4 and selected T3 head and neck cancer before and, on average, 19 weeks after completion of treatment.


RESULTS
The Performance Status Scale demonstrated worse scores for both eating in public (P =.004) and normalcy of diet (P =.004) after treatment. Patients who underwent neck dissections had significantly worse scores (P =.02) in normalcy of diet. A significant decline was noted in swallowing functional measures at the time of the repeat evaluation (P =.02). Videofluoroscopic swallow studies revealed altered swallow function in 9 of 11 patients before treatment, with aspiration seen in 3 patients. Following treatment, the incidence of aspiration increased to seven patients. Tongue base retraction, reduced laryngeal elevation, and increased laryngeal vestibule penetration of thick liquid were all statistically significantly worse after treatment. The overall score on the quality of life instrument was not significantly changed from before to after treatment.


CONCLUSIONS
The majority of patients demonstrated significantly worse swallow function on all three methods of analysis at 19 weeks after completion of treatment. Continued detailed monitoring of patients' swallow function is critical in determining long-term effects of intra-arterial chemoradiation therapy and neck dissection.
Graner
Darlene E
DE
Department of Neurology, Division of Radiation Oncology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. graner.darlene@mayo.edu
Foote
Robert L
RL
Kasperbauer
Jan L
JL
Stoeckel
Ruth E
RE
Okuno
Scott H
SH
Olsen
Kerry D
KD
Sabri
Alain N
AN
Maragos
Nicolas E
NE
Cha
Stephen S
SS
Sargent
Dan J
DJ
Strome
Scott E
SE
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D009367:Neoplasm Staging; D011446:Prospective Studies; D012720:Severity of Illness Index