Prospective subjective evaluation of swallowing function and dietary pattern in head and neck cancers treated with concomitant chemo-radiation.
OBJECTIVE
Prospective subjective evaluation of swallowing function and dietary pattern in locally advanced head and neck cancer patients treated with concomitant chemo-radiotherapy (CRT).


METHODS
Prospective evaluation of swallowing function with performance status scale for head and neck cancer patients (PSSHN) at pre-CRT, CRT completion and at subsequent follow-ups in adult with loco-regionally advanced head and neck squamous cell carcinoma (HNSCC) patients.


RESULTS
In 47 patients (40 male, seven females; mean age 53; 72% smoker 53%, oropharyngeal cancer), the mean total PSSHN score at pre-CRT was 258.5 and decreased to 225.2 and 219.2 at two and six months respectively. Understandability of speech, normalcy in diet and eating in public at pre-CRT and six months were 91.5 and 84.4; 80.4 and 63.1; 87.3 and 76.6 respectively. In univariate analysis, pre-CRT PSSHN scores were significantly lesser in patients with severe pre-CRT dysphagia (P = 0.001), hypopharyngeal cancer (P = 0.244) and advanced T-stage (T3/4) disease (P = 0.144). At CRT completion, there was significant reduction of PSSHN scores in patients with severe pre-CRT dysphagia (P = 0.008), post-CRT weight loss (>10%) and disease progression (P = 0.039). At two months and six months, 17 (57%) and 11 (73.5%) patients respectively showed change in dietary habit. Mean increase in meal time was 13% and 21% at two and six-month follow-up.


CONCLUSIONS
HNSCC patients show deterioration in swallowing function after CRT with normalcy of diet in maximum and eating in public least affected. Pre-CRT severity of dysphagia, weight loss> 10% and disease progression have significant correlation with higher swallowing function deterioration after CRT.
Agarwal
Jaiprakash
J
Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.
Dutta
Debnarayan
D
Palwe
Vijay
V
Gupta
Tejpal
T
Laskar
Sarbani Ghosh
SG
Budrukkar
Ashwini
A
Murthy
Vedang
V
Chaturvedi
Pankaj
P
Pai
Prathemesh
P
Chaukar
Devendra
D
D'Cruz
A K
AK
Kulkarni
Suyesh
S
Kulkarni
Aniruddh
A
Baccher
Gurmit
G
Shrivastava
Shyam Kishor
SK
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000628:therapy*; D003679:Deglutition / Q000187:drug effects / Q000528:radiation effects; D003680:Deglutition Disorders / Q000453:epidemiology* / Q000209:etiology; D003906:Developing Countries; D004032:Diet; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000628:therapy*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects; D012720:Severity of Illness Index
D000970:Antineoplastic Agents