title: Swallowing, nutrition and patient-rated functional outcomes at 6 months following two non-surgical treatments for T1-T3 oropharyngeal cancer.
abstract: OBJECTIVE
  Altered fractionation radiotherapy with concomitant boost (AFRT-CB) may be considered an alternative treatment for patients not appropriate for chemoradiation (CRT). As functional outcomes following AFRT-CB have been minimally reported, this exploratory paper describes the outcomes of patients managed with AFRT-CB or CRT at 6 months post-treatment.
  
  
  METHODS
  Using a cross-sectional analysis design, functional outcomes of 14 AFRT-CB and 17 CRT patients with T1-T3 oropharyngeal cancers were explored at 6 months post-treatment. Clinical and instrumental swallow assessments, weight and nutritional status, and the functional impact of treatment were examined.
  
  
  RESULTS
  Inferior outcomes were observed for the CRT patients on the RBHOMS (p = 0.03) which was reflected in diet and fluid restrictions with 18% of the CRT group requiring modified fluids and diets. Although a trend (p = 0.07) was noted for increased lingual deficits and aspiration risk for fluids in the CRT group, no other significant differences were observed. Both groups experienced an average of 10 kg weight loss and reported reduced general and swallowing-related function.
  
  
  CONCLUSIONS
  These preliminary data suggest functional outcomes following AFRT-CB and CRT were largely comparable at 6 months post-treatment. Treatment intensification in any form may contribute to impaired function which requires multidimensional intervention. Larger cohort investigations with systematic methodology are needed to further examine these initial findings.
authors.affiliation: Division of Speech Pathology, The University of Queensland and Speech Pathology Department, Princess Alexandra Hospital, Woolloongabba, QLD, 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: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D003430:Cross-Sectional Studies; D003679:Deglutition / Q000187:drug effects / Q000528:radiation effects; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011793:Queensland; D020266:Radiotherapy, Conformal; D057566:Self Report
references.citation: Head Neck. 1998 Sep;20(6):540-8
references.pmid: 9702542
references.citation: Eur Arch Otorhinolaryngol. 2009 Jun;266(6):889-900
references.pmid: 18825400
references.citation: Support Care Cancer. 2008 Mar;16(3):285-9
references.pmid: 17680281
references.citation: Int J Radiat Oncol Biol Phys. 2009 Feb 1;73(2):410-5
references.pmid: 18635320
references.citation: Arch Otolaryngol Head Neck Surg. 2001 Jul;127(7):870-6
references.pmid: 11448365
references.citation: Laryngoscope. 2004 Aug;114(8):1362-7
references.pmid: 15280708
references.citation: Head Neck. 2007 Jul;29(7):632-7
references.pmid: 17230558
references.citation: Int J Radiat Oncol Biol Phys. 2003 Dec 1;57(5):1219-30
references.pmid: 14630255
references.citation: Dysphagia. 1996 Spring;11(2):93-8
references.pmid: 8721066
references.citation: J Clin Oncol. 2008 Jul 20;26(21):3582-9
references.pmid: 18559875
references.citation: Radiother Oncol. 1999 Aug;52(2):157-64
references.pmid: 10577701
references.citation: Head Neck. 2002 Jun;24(6):555-65
references.pmid: 12112553
references.citation: Otolaryngol Head Neck Surg. 2006 Jun;134(6):916-22
references.pmid: 16730530
references.citation: Int J Radiat Oncol Biol Phys. 2000 Aug 1;48(1):7-16
references.pmid: 10924966
references.citation: Radiother Oncol. 1997 Apr;43(1):39-46
references.pmid: 9165135
references.citation: Head Neck. 2006 Jan;28(1):64-73
references.pmid: 16302193
references.citation: Clin Nutr. 2006 Oct;25(5):765-72
references.pmid: 16698130
references.citation: Radiother Oncol. 2001 Dec;61(3):223-31
references.pmid: 11730991
references.citation: Int J Radiat Oncol Biol Phys. 1990 Dec;19(6):1339-45
references.pmid: 2262355
references.citation: Arch Otolaryngol Head Neck Surg. 2007 Jun;133(6):533-40
references.pmid: 17576902
references.citation: Dysphagia. 2012 Mar;27(1):32-45
references.pmid: 21344190
references.citation: Am J Clin Oncol. 2005 Aug;28(4):359-66
references.pmid: 16062077
references.citation: Head Neck. 2008 Feb;30(2):148-58
references.pmid: 17786992
references.citation: J Clin Oncol. 2003 Jan 1;21(1):92-8
references.pmid: 12506176
references.citation: Laryngoscope. 2003 Mar;113(3):573-9
references.pmid: 12616217
references.citation: J Clin Oncol. 1993 Mar;11(3):570-9
references.pmid: 8445433
references.citation: J Clin Oncol. 1999 Mar;17(3):1020-8
references.pmid: 10071297
references.citation: J Speech Lang Hear Res. 2000 Oct;43(5):1264-74
references.pmid: 11063246
references.citation: Head Neck. 2004 Apr;26(4):365-72
references.pmid: 15054740
references.citation: Head Neck. 2006 Dec;28(12):1069-76
references.pmid: 16823874
references.citation: Int J Radiat Oncol Biol Phys. 2000 Apr 1;47(1):1-12
references.pmid: 10758302
references.citation: Radiother Oncol. 2008 May;87(2):181-7
references.pmid: 18215435
references.citation: Radiother Oncol. 2009 Jul;92(1):4-14
references.pmid: 19446902
references.citation: Head Neck. 2009 Jan;31(1):77-84
references.pmid: 18972429