title: A prospective investigation of swallowing, nutrition, and patient-rated functional impact following altered fractionation radiotherapy with concomitant boost for oropharyngeal cancer.
abstract: Altered fractionation radiotherapy for head and neck cancer has been associated with improved locoregional control, overall survival, and heightened toxicity compared with conventional treatment. Swallowing, nutrition, and patient-perceived function for altered fractionation radiotherapy with concomitant boost (AFRT-CB) for T1-T3 oropharyngeal squamous cell carcinoma (SCC) have not been previously reported. Fourteen consecutive patients treated with AFRT-CB for oropharyngeal SCC were recruited from November 2006 to August 2009 in a tertiary hospital in Brisbane, Australia. Swallowing, nutrition, and patient-perceived functional impact assessments were conducted pretreatment, at 4-6 weeks post-treatment, and at 6 months post-treatment. Deterioration from pretreatment to 4-6 weeks post-treatment in swallowing, nutrition, and functional impact was evident, likely due to the heightened toxicity associated with AFRT-CB. There was significant improvement at 6 months post-treatment in functional swallowing, nutritional status, patient-perceived swallowing, and overall function, consistent with recovery from acute toxicity. However, weight and patient perception of physical function and side effects remained significantly worse than pretreatment scores. The ongoing deficits related to weight and patient-perceived outcomes at 6 months revealed that this treatment has a long-term impact on function possibly related to the chronic effects of AFRT-CB.
authors.affiliation: Speech Pathology Department, Princess Alexandra Hospital, Australia. bena.cartmill@gmail.com
authors.forename: Bena
authors.initials: B
authors.lastname: Cartmill
authors.forename: Petrea
authors.initials: P
authors.lastname: Cornwell
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ward
authors.forename: Wendy
authors.initials: W
authors.lastname: Davidson
authors.forename: Sandro
authors.initials: S
authors.lastname: Porceddu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D003679:Deglutition / Q000528:radiation effects*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D019583:Dose Fractionation, Radiation; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000528:radiation effects*; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy*; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome