Dysphagia severity and aspiration following postoperative radiation for locally advanced oropharyngeal cancer.
The aim of the present study was to assess dysphagia severity following postoperative radiation for locally advanced oropharyngeal cancer.


METHODS
Eighteen patients with oropharyngeal carcinoma had undergone postoperative radiation. There were eight base of tongue, eight tonsils, and two soft palate carcinomas. All the patients had undergone modified barium swallow (MBS) to assess the persistence of dysphagia (more than one month) post-treatment. All the patients were cancer-free at the time of the swallowing study. Dysphagia severity was graded as 1-7.


RESULTS
At a median follow-up of 12 months, there were three grade 2, four grade 3, two grade 4, five grade 5, two grade 6, and two grade 7. Only three patients (17%) had normal swallow post-treatment. Six patients (33%) had mild to moderate dysphagia (grade 3-4). Nine patients (50%) developed aspiration (grade 5-7). Among the patients who developed aspiration, four (22%) required tube feeding for severe aspiration.


CONCLUSIONS
Long-term (more than one year) dysphagia following postoperative radiation for oropharyngeal cancer may be symptomatic of permanent damage to the swallowing mechanism. Evaluation of patients who complain of persistence of dysphagia a year or more following treatment should include MBS, because of the increased risk of aspiration.
Nguyen
Nam P
NP
Department Radiation Oncology, University of Arizona, 1501 N. Campbell Ave, Tucson, AZ 85724-5081, USA. NamPhong.Nguyen@yahoo.com
Frank
Cheryl
C
Moltz
Candace C
CC
Vos
Paul
P
Millard
Carrie
C
Smith
Herbert J
HJ
Dutta
Suresh
S
Lee
Howard
H
Martinez
Tomas
T
Karlsson
Ulf
U
Nguyen
Ly M
LM
Sallah
Sabah
S
D000368:Aged; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000150:complications* / Q000532:radiotherapy / Q000601:surgery