title: Factors associated with long-term speech and swallowing outcomes after chemoradiotherapy for locoregionally advanced head and neck cancer.
abstract: OBJECTIVE
  to identify factors that influence patient-centered measures of speech and swallowing function after successful use of chemoradiotherapy to treat cancers of the head and neck.
  
  
  METHODS
  patients previously enrolled in a phase 2 trial using induction chemotherapy consisting of carboplatin and paclitaxel followed by chemoradiotherapy with paclitaxel, fluorouracil, hydroxyurea, and 1 of 3 radiation dose levels were assigned speaking and swallowing scores at follow-up ranging from 1 to 4, with 1 representing normal speech or swallowing and 4 representing significant sustained deficits.
  
  
  METHODS
  one hundred eighty-four patients with locoregionally advanced head and neck cancer.
  
  
  METHODS
  speech and swallowing function after chemoradiotherapy.
  
  
  RESULTS
  of the 222 patients originally enrolled in the trial, 184 were alive and free of locoregional recurrence at the outset of this study. Of these eligible patients, 163 (88.6%) were assigned a speaking score of 1 through 4 at an average of 34.8 (range, 1.5-76.4) months after completion of treatment, whereas 166 patients (90.2%) were assigned a swallowing score of 1 through 4 at an average of 34.5 (range, 1.0-76.4) months after completion of treatment. Most patients (84.7% with speaking scores and 63.3% with swallowing scores) had no residual deficit and were assigned scores of 1. Factors that were associated with worse speaking outcomes included female sex, smoking history, hypopharyngeal or laryngeal primary sites, and poor response to induction chemotherapy; factors associated with worse swallowing outcomes included advanced patient age, poor performance status, primary site, and neck dissection.
  
  
  CONCLUSIONS
  among patients successfully treated for locoregionally advanced cancers of the head and neck, several factors correlate with speaking and swallowing outcomes. Because advances in therapy have led to improved survival in these patients, understanding and controlling adverse effects of treatment should continue to be an active area of investigation.
authors.affiliation: Department of Radiation Oncology, Duke University Medical Center, PO Box 3085, Durham, NC 27710, USA.
authors.forename: Kent W
authors.initials: KW
authors.lastname: Mouw
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Haraf
authors.forename: Kerstin M
authors.initials: KM
authors.lastname: Stenson
authors.forename: Ezra E
authors.initials: EE
authors.lastname: Cohen
authors.forename: Xi
authors.initials: X
authors.lastname: Xi
authors.forename: Mary Ellyn
authors.initials: ME
authors.lastname: Witt
authors.forename: Marcy
authors.initials: M
authors.lastname: List
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Blair
authors.forename: Everett E
authors.initials: EE
authors.lastname: Vokes
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Salama
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003679:Deglutition / Q000502:physiology*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D006801:Humans; D011379:Prognosis; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents