Dysphagia after sequential chemoradiation therapy for advanced head and neck cancer.
OBJECTIVE
Assess impact of sequential chemoradiation therapy (SCRT) for advanced head and neck cancer (HNCA) on swallowing, nutrition, and quality of life.


METHODS
Prospective cohort study of 59 patients undergoing SCRT for advanced head and neck cancer. Follow-up median was 47.5 months.


METHODS
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.


CONCLUSIONS
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.


CONCLUSIONS
Dysphagia is significant after SCRT but generally slowly recovers 6 to 12 months after SCRT.


METHODS
C-4.
Goguen
Laura A
LA
Department of Surgery/Division of Otolaryngology, at the Brigham and Women's Hospital and the Dana Farber Cancer Institute, Boston, MA 02115, USA. lgoguen@partners.org
Posner
Marshall R
MR
Norris
Charles M
CM
Tishler
Roy B
RB
Wirth
Lori J
LJ
Annino
Donald J
DJ
Gagne
Adele
A
Sullivan
Christopher A
CA
Sammartino
Daniel E
DE
Haddad
Robert I
RI
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology; D004032:Diet / Q000145:classification; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D016896:Treatment Outcome