title: A swallow preservation protocol improves function for veterans receiving chemoradiation for head and neck cancer.
abstract: OBJECTIVE
  Determine the efficacy of a swallow preservation protocol (SPP) on maintaining swallow function in patients undergoing chemoradiation (CRT) or radiation therapy alone (RT) for head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Veterans Affairs medical center.
  
  
  METHODS
  Patients treated with CRT or RT for HNSCC between February 2006 and November 2013 were studied. Those enrolled in the SPP participated in swallowing, jaw, and tongue exercises during cancer therapy. The comparator group received no swallowing intervention during CRT. A previously described functional outcome swallowing scale (FOSS; 0 = no symptoms and 5 = nonoral feeding for all nutrition) was used to quantify dysphagia prior to and at the completion of cancer therapy, and an analysis was performed to compare swallowing function.
  
  
  RESULTS
  Forty-one (all male; mean age, 66 years) and 66 patients (all male; mean age, 61 years) were included in the SPP and comparator groups, respectively. In the SPP group, mean pre- and posttreatment FOSS scores were 2.2 and 2.2, respectively, while the corresponding scores in the comparator group were 1.8 and 2.7, respectively, with posttreatment FOSS scores being significantly worse than pretreatment FOSS scores in the comparator group only.
  
  
  CONCLUSIONS
  Patients enrolled in the SPP demonstrated preserved swallowing function over the course of cancer treatment compared with a comparator group. This confirms the importance of early evaluation and intervention for dysphagia prior to and during CRT or RT alone.
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA kap@ucla.edu.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Peng
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Kuan
authors.affiliation: Department of Audiology and Speech Pathology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Unger
authors.affiliation: Department of Radiation Oncology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Lorentz
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.
authors.forename: Marilene B
authors.initials: MB
authors.lastname: Wang
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA Research Service, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Long
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy; D002985:Clinical Protocols; D003679:Deglutition; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D020127:Recovery of Function; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D014728:Veterans
keywords: chemoradiation; dysphagia; head and neck cancer; swallow preservation
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