title: Functional outcomes following chemoradiotherapy for head and neck cancer.
abstract: OBJECTIVE
  To study functional outcomes following concurrent chemoradiotherapy of head and neck cancer.
  
  
  METHODS
  A retrospective chart review assessed diet, feeding tube use, and tracheotomy pretreatment and 3, 6, 12, and 24 months posttreatment.
  
  
  RESULTS
  Of 196 patients who underwent chemoradiotherapy between 1990 and 2002, 148 (76%) required feeding tubes immediately posttreatment; 150 (77%) required nutritional support at 3 months. By 12 months, 92% were tube-free and 83% resumed near-normal diet. Of 17 patients (9%) with tracheotomy posttreatment, 71% were decannulated by 6 months. Stage IV disease strongly predicted prolonged feeding tube use and slow recovery of diet; age > or =60 also predicted slow recovery. Primary site, gender, and radiotherapy schedule did not predict functional recovery after adjusting for stage and age.
  
  
  CONCLUSIONS
  Few patients required tracheotomy before or during chemoradiotherapy. Many patients required feeding tubes and nutritional support for several months following therapy, but most were tube-free and eating near-normal diets within 1 year.
  
  
  METHODS
  C.
authors.affiliation: Department of Otolaryngology and Communicative Disorders, The Cleveland Clinic Foundation, Ohio 44195, USA. AKSTL@ccf.org
authors.forename: Lee M
authors.initials: LM
authors.lastname: Akst
authors.forename: James
authors.initials: J
authors.lastname: Chan
authors.forename: Paul
authors.initials: P
authors.lastname: Elson
authors.forename: Jerrold
authors.initials: J
authors.lastname: Saxton
authors.forename: Marshall
authors.initials: M
authors.lastname: Strome
authors.forename: David
authors.initials: D
authors.lastname: Adelstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004032:Diet; D004750:Enteral Nutrition; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D014140:Tracheotomy; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil