title: Swallowing outcomes in patients with oropharyngeal cancer undergoing organ-preservation treatment.
abstract: BACKGROUND
  The purpose of this study was to assess swallowing outcomes in a cohort of patients with oropharyngeal squamous cell carcinoma (SCC) undergoing nonoperative treatment.
  
  
  METHODS
  We conducted a retrospective study of patients who completed videofluoroscopic swallowing studies (VFSS) after nonoperative treatment of oropharyngeal SCC. All patients received intensity-modulated radiation therapy (IMRT) ± chemotherapy. Swallowing abnormalities were recorded and the Penetration Aspiration Scale (PAS) quantified airway infiltration.
  
  
  RESULTS
  Posttreatment VFSS (n = 71) occurred at an average of 4.69 months posttreatment. Abnormal PAS was noted in 45% of swallow studies. Swallowing decompensations included reduced pharyngeal constriction (75%), epiglottic tilt (70%), cricopharyngeal opening (42%), and hyoid excursion (42%). The only variable independently associated with abnormal PAS was pretreatment swallowing difficulty (odds ratio [OR] = 4.02; p = .009).
  
  
  CONCLUSIONS
  This study demonstrates that patients undergoing nonsurgical treatment for oropharyngeal SCC are at risk for posttreatment dysphagia. This suggests a need for dysphagia evaluation/management and refinement of interventions to minimize dysphagia.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Starmer
authors.forename: Donna
authors.initials: D
authors.lastname: Tippett
authors.forename: Kimberly
authors.initials: K
authors.lastname: Webster
authors.forename: Harry
authors.initials: H
authors.lastname: Quon
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Jones
authors.forename: Sarah
authors.initials: S
authors.lastname: Hardy
authors.forename: Christine G
authors.initials: CG
authors.lastname: Gourin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D059248:Chemoradiotherapy; D003679:Deglutition; D003680:Deglutition Disorders / Q000453:epidemiology*; D005260:Female; D005471:Fluoroscopy; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D011183:Postoperative Complications / Q000453:epidemiology*; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: chemoradiation; dysphagia; head and neck cancer; oropharyngeal cancer; swallowing