title: Swallow preservation exercises during chemoradiation therapy maintains swallow function.
abstract: OBJECTIVE
  To evaluate a swallow preservation protocol (SPP) in which patients received swallow therapy before, during, and after radiation treatment and its efficacy in maintaining swallowing function in head and neck cancer patients.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary care academic medical center.
  
  
  METHODS
  Eighty-five patients who received radiation (RT) or chemoradiation (CRT) participated in the SPP from 2007 to 2012. Subjects were divided into 2 groups: compliant and noncompliant with SPP. At each SPP visit, the diet of each patient was recorded as regular (chewable), puree, liquid, or gastrostomy tube (G-tube) dependent, along with their compliance with the swallow exercises. Patients were stratified by age, gender, tumor stage, type of treatment, radiation dose, diet change, dysguesia, odynophagia, pain, and stenosis. Statistical analysis was performed comparing the 2 compliance groups in regards to swallowing-related outcomes at 1 month after completion of therapy.
  
  
  RESULTS
  Fifty-seven patients were compliant and 28 were noncompliant with SPP during treatment. The compliant group had a higher percentage of patients tolerating a regular diet (54.4% vs 21.4%, P = .008), a lower G-tube dependence (22.8% vs 53.6%, P = .008), and a higher rate of maintaining or improving their diet (54.4% vs 25.0%, P = .025) compared to noncompliant patients.
  
  
  CONCLUSIONS
  A swallow preservation protocol appears to help maintain or improve swallow function in head and neck cancer patients undergoing RT or CRT. Patients who are able to comply with swallow exercises are less likely to worsen their diet, receive a G-tube, or develop stenosis.
authors: Department of Head and Neck Surgery, David E. Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors: Victor M
authors: VM
authors: Duarte
authors: Dinesh K
authors: DK
authors: Chhetri
authors: Yuan F
authors: YF
authors: Liu
authors: Andrew A
authors: AA
authors: Erman
authors: Marilene B
authors: MB
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects; D003679:Deglutition / Q000187:drug effects* / Q000528:radiation effects*; D003680:Deglutition Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: radiation and swallow; swallow preservation; swallow therapy
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