Risk of aspiration following radiation for non-nasopharyngeal head and neck cancer.
OBJECTIVE
We assessed the rate of aspiration following radiation for non-nasopharyngeal head and neck cancer.


METHODS
Retrospective study.


METHODS
Veterans Administration Hospital.


METHODS
Thirty-three patients who underwent radiation for head and neck cancer. Modified barium swallow was performed prior to and following treatment to assess the persistence of dysphagia and aspiration risk. All patients were cancer free at the time of the swallowing study. Dysphagia severity was graded from 1 to 7.


RESULTS
Preradiation baseline dysphagia was observed as follows: 10 grade 1, 14 grade 2, 9 grade 3, and 1 grade 4. Following radiation, at a median follow-up of 3 months, nine patients had grade 1, eight patients had grade 2, six patients had grade 3, two patients had grade 4, three patients had grade 5, two patients had grade 6, and three patients had grade 7. Overall, 24% (8 of 33) of the patients developed aspiration (grades 5-7). Fifteen percent (5 of 33) of the patients had severe aspiration (grades 6-7) requiring tube feedings. All patients who developed severe aspiration continued to require tube feedings more than 1 year following treatment completion.


CONCLUSIONS
Aspiration is a significant source of morbidity following radiation for non-nasopharyngeal head and neck cancer. Aspiration may develop for all tumour stages or sites. Diagnostic studies such as modified barium swallow should be included in future prospective head and neck cancer studies to assess the prevalence of aspiration because of its often silent nature.
Nguyen
Nam P
NP
Department of Radiation Oncology, University of Arizona, Tucson, AZ 85724-5081, USA. NamPhong.Nguyen@yahoo.com
Frank
Cheryl
C
Moltz
Candace C
CC
Millar
Carrie
C
Vos
Paul
P
Smith
Herbert J
HJ
Dutta
Suresh
S
Karlsson
Ulf
U
Nguyen
Phuc D
PD
Nguyen
Ly M
LM
Lemanski
Claire
C
Sallah
Sabah
S
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011015:Pneumonia, Aspiration / Q000453:epidemiology / Q000209:etiology*; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013781:Texas