title: Swallowing in the first year after chemoradiotherapy for head and neck cancer: clinician- and patient-reported outcomes.
abstract: BACKGROUND
  This prospective study evaluated swallowing outcomes prechemoradiotherapy (pre-CRT) up to 1 year post-CRT, in a substantial cohort of patients with head and neck cancer and explored factors predicting outcome.
  
  
  METHODS
  One hundred twelve patients were assessed pretreatment and at 3, 6, and 12 months posttreatment using a questionnaire, endoscopic assessment, water swallow test, and diet score.
  
  
  RESULTS
  Seventy-one patients were retained, the majority had oropharyngeal (53%) or hypopharyngeal cancer (20%). A marked deterioration occurred between pretreatment and 3 months posttreatment (p ≤ .01). Significant improvement between 3 and 12 months was found on 2 swallowing measures, but not self reported. Three of the 4 pretreatment assessments predicted outcomes at 1 year.
  
  
  CONCLUSIONS
  CRT results in a marked deterioration on different paradigms of swallowing measurements. Improvement occurs on some clinical measures, but limited change is observed in patients' perceptions. Pretreatment measures are important indicators of long-term dysphagia. Swallowing recovery is complex, taking different courses between clinical tests and perspectives.
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Patterson
authors.forename: Elaine
authors.initials: E
authors.lastname: McColl
authors.forename: Paul N
authors.initials: PN
authors.lastname: Carding
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Hildreth
authors.forename: Charles
authors.initials: C
authors.lastname: Kelly
authors.forename: Janet A
authors.initials: JA
authors.lastname: Wilson
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use; D003679:Deglutition; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000628:therapy; D007822:Laryngeal Neoplasms / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D009303:Nasopharyngeal Neoplasms / Q000628:therapy; D009959:Oropharyngeal Neoplasms / Q000628:therapy; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016685:Mitomycin; D002945:Cisplatin
keywords: chemoradiotherapy; dysphagia; head and neck cancer; swallowing assessment