title: Aspiration rate following nonsurgical therapy for laryngeal cancer.
abstract: The aim of this study was to evaluate the aspiration rate following nonsurgical therapy, i.e. chemoradiation or radiation alone for laryngeal cancer. Modified barium swallow was performed in 43 patients who complained of dysphagia following chemoradiation (n = 22) or radiation alone (n = 21) for laryngeal cancer. Patients were selected if they were cancer free at the time of the swallowing study. Dysphagia severity was graded on a scale of 1-7. Patients were grouped according to the dysphagia severity: no aspiration (grade 1-4), and severe (grade 5-7). Mean and median dysphagia grades were 4.4/5 and 3.5/3 for chemoradiation and radiation, respectively. Aspiration occurred in 12 patients (54%) of the chemoradiation group and 7 (33%) of the radiation alone group (p = 0.13). There was a higher proportion of patients with large tumor (T3-T4) in the chemoradiation group (64%) compared to the radiation group (5%) (p = 0.0001). Aspiration is a significant source of morbidity in patients treated for laryngeal cancer with chemoradiation or radiation alone. Aspiration occurred in both groups. Although the observed difference in aspiration rates did not achieve statistical significance, the higher aspiration rate in the chemoradiation group may be due to a higher proportion of large tumors, to the additional toxic effect of chemotherapy, or to the small number of patients in both groups. Diagnostic studies such as modified barium swallow should be part of future laryngeal cancer prospective studies to assess the prevalence of aspiration as it may be silent.
authors.affiliation: Department of Radiation Oncology, University of Arizona, Tucson, AZ 85124-5081, USA. namphong.nguyen@yahoo.com
authors.forename: Nam P
authors.initials: NP
authors.lastname: Nguyen
authors.forename: Candace C
authors.initials: CC
authors.lastname: Moltz
authors.forename: Cheryl
authors.initials: C
authors.lastname: Frank
authors.forename: Paul
authors.initials: P
authors.lastname: Vos
authors.forename: Carrie
authors.initials: C
authors.lastname: Millar
authors.forename: Herbert J
authors.initials: HJ
authors.lastname: Smith
authors.forename: Howard
authors.initials: H
authors.lastname: Lee
authors.forename: Ulf
authors.initials: U
authors.lastname: Karlsson
authors.forename: Phuc D
authors.initials: PD
authors.lastname: Nguyen
authors.forename: Tomas
authors.initials: T
authors.lastname: Martinez
authors.forename: Ly M
authors.initials: LM
authors.lastname: Nguyen
authors.forename: Sabah
authors.initials: S
authors.lastname: Sallah
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001465:Barium Radioisotopes; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D001465:Barium Radioisotopes