title: Impact of xerostomia on dysphagia after chemotherapy-intensity-modulated radiotherapy for oropharyngeal cancer: Prospective longitudinal study.
abstract: The purpose of this study was to assess how xerostomia affects dysphagia.
  
  
  
  Prospective longitudinal studies of 93 patients with oropharyngeal cancer treated with definitive chemotherapy-intensity-modulated radiotherapy (IMRT). Observer-rated dysphagia (ORD), patient-reported dysphagia (PRD), and patient-reported xerostomia (PRX) assessment of the swallowing mechanics by videofluoroscopy (videofluoroscopy score), and salivary flow rates, were prospectively assessed from pretherapy through 2 years.
  
  
  
  ORD grades ≥2 were rare and therefore not modeled. Of patients with no/mild videofluoroscopy abnormalities, a substantial proportion had PRD that peaked 3 months posttherapy and subsequently improved. Through 2 years, highly significant correlations were observed between PRX and PRD scores for all patients, including those with no/mild videofluoroscopy abnormalities. Both PRX and videofluoroscopy scores were highly significantly associated with PRD. On multivariate analysis, PRX score was a stronger predictor of PRD than the videofluoroscopy score.
  
  
  
  Xerostomia contributes significantly to PRD. Efforts to further decrease xerostomia, in addition to sparing parotid glands, may translate into improvements in PRD. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1605-E1612, 2016.
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Vainshtein
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Stuart
authors.initials: S
authors.lastname: Samuels
authors.affiliation: Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
authors.forename: Yebin
authors.initials: Y
authors.lastname: Tao
authors.affiliation: Department of Speech Pathology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Teresa
authors.initials: T
authors.lastname: Lyden
authors.affiliation: Department of Speech Pathology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Marc
authors.initials: M
authors.lastname: Haxer
authors.affiliation: Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Matthew
authors.initials: M
authors.lastname: Spector
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.|Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
authors.forename: Matthew
authors.initials: M
authors.lastname: Schipper
authors.affiliation: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Avraham
authors.initials: A
authors.lastname: Eisbruch
mesh_terms: D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy*; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D014987:Xerostomia / Q000503:physiopathology*
keywords: dysphagia; head neck cancer; intensity-modulated radiotherapy (IMRT); patient-reported outcomes; xerostomia