title: Long-term functional and survival outcomes after induction chemotherapy and risk-based definitive therapy for locally advanced squamous cell carcinoma of the head and neck.
abstract: BACKGROUND
  The purpose of this study was to evaluate long-term outcomes after induction chemotherapy followed by "risk-based" local therapy for locally-advanced squamous cell carcinoma of the head and neck (SCCHN).
  
  
  METHODS
  Forty-seven patients (stage IV; ≥N2b) were enrolled in a phase II trial. Baseline and 24-month functional measures included modified barium swallow (MBS) studies, oropharyngeal swallow efficiency (OPSE), and the MD Anderson Dysphagia Inventory (MDADI). Functional status was assessed at 5 years.
  
  
  RESULTS
  Five-year overall survival (OS) was 89% (95% confidence interval [CI], 81% to 99%). A nonsignificant 13% average reduction in swallowing efficiency (OPSE) was observed at 24 months relative to baseline (p = .191). MDADI scores approximated baseline at 24 months. Among 42 long-term survivors (median, 5.9 years), 3 patients (7.1%) had chronic dysphagia. The rate of final gastrostomy dependence was 4.8% (2 of 42).
  
  
  CONCLUSIONS
  Sequential chemoradiotherapy achieved favorable outcomes among patients with locally advanced SCCHN, mainly of oropharyngeal origin. MBS and MDADI scores found modest swallowing deterioration at 2 years, and chronic aspiration was uncommon in long-term survivors.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Hutcheson
authors.forename: Jan S
authors.initials: JS
authors.lastname: Lewin
authors.forename: F Christopher
authors.initials: FC
authors.lastname: Holsinger
authors.forename: Ganene
authors.initials: G
authors.lastname: Steinhaus
authors.forename: Asher
authors.initials: A
authors.lastname: Lisec
authors.forename: Denise A
authors.initials: DA
authors.lastname: Barringer
authors.forename: Heather Y
authors.initials: HY
authors.lastname: Lin
authors.forename: Sandra
authors.initials: S
authors.lastname: Villalobos
authors.forename: Adam S
authors.initials: AS
authors.lastname: Garden
authors.forename: Vali
authors.initials: V
authors.lastname: Papadimitrakopoulou
authors.forename: Merrill S
authors.initials: MS
authors.lastname: Kies
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D000068818:Cetuximab; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D005774:Gastrostomy / Q000706:statistics & numerical data*; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D016190:Carboplatin; D017239:Paclitaxel; D000068818:Cetuximab
keywords: functional outcomes; induction chemotherapy; locally advanced squamous carcinoma; sequential chemoradiotherapy; swallowing