Aspiration occurence during chemoradiation for head and neck cancer.
OBJECTIVE
To assess the risk of developing aspiration during chemoradiation for head and neck cancer.


METHODS
A retrospective review of 114 patients who underwent concurrent chemoradiation for locally advanced head and neck cancer was undertaken. Patients were determined as having aspiration if they had pneumonia on chest-X-ray (CXR) and/or had documented aspiration on the modified barium swallow (MBS) during their treatment.


RESULTS
Fifteen patients (13%) developed aspiration during chemoradiation. Twelve patients (10%) had aspiration demonstrated on CXR alone (9 patients) or combined with MBS (3 patients). Three patients (3%) had aspiration on MBS alone. Three of the six patients with aspiration observed on MBS had normal swallowing on their pretreatment MBS. All 15 patients had severe mucositis and neutropenia at the time of the aspiration. Despite broad-spectrum antibiotics and supportive care, six patients (5%) died.


CONCLUSIONS
Aspiration may develop during chemoradiation for head and neck cancer because of radiation-induced altered swallow.
Nguyen
Nam P
NP
Department of Radiation Oncology, University of Arizona, Tucson, AZ 85724-5081, USA. NamPhong.Nguyen@yahoo.com
Smith
Herbert J
HJ
Dutta
Suresh
S
Alfieri
Alan
A
North
Debra
D
Nguyen
Phuc D
PD
Lee
Howard
H
Martinez
Tomas
T
Lemanski
Claire
C
Ludin
Adir
A
Nguyen
Ly M
LM
Sallah
Sabah
S
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D011859:Radiography; D011878:Radiotherapy / Q000009:adverse effects; D053120:Respiratory Aspiration / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D012306:Risk