title: Change of Swallowing in Patients With Head and Neck Cancer After Concurrent Chemoradiotherapy.
abstract: OBJECTIVE
  To evaluate the functional characteristics of swallowing and to analyze the parameters of dysphagia in head and neck cancer patients after concurrent chemoradiotherapy (CCRT).
  
  
  METHODS
  The medical records of 32 patients with head and neck cancer who were referred for a videofluoroscopic swallowing study from January 2012 to May 2015 were retrospectively reviewed. The patients were allocated by duration after starting CCRT into early phase (<1 month after radiation therapy) and late phase (>1 month after radiation therapy) groups. We measured the modified penetration aspiration scale (MPAS) and American Speech-Language-Hearing Association National Outcome Measurement System swallowing scale (ASHA-NOMS). The oral transit time (OTT), pharyngeal delay time (PDT), and pharyngeal transit time (PTT) were recorded to assess the swallowing physiology.
  
  
  RESULTS
  Among 32 cases, 18 cases (56%) were of the early phase. In both groups, the most common tumor site was the hypopharynx (43.75%) with a histologic type of squamous cell carcinoma (75%). PTT was significantly longer in the late phase (p=0.03). With all types of boluses, except for soup, both phases showed a statistically significant difference in MPAS results. The mean ASHA-NOMS level for the early phase was 5.83±0.78 and that for the late phase was 3.79±1.80, with statistical significance (p=0.01). The PTT and ASHA-NOMS level showed a statistically significant correlation (correlation coefficient=-0.52, p=0.02). However, it showed no relationship with the MPAS results.
  
  
  CONCLUSIONS
  The results of our study suggest that in the late phase that after CCRT, the OTT, PDT, and PTT were longer than in the early phase and the PTT prolongation was statistically significant. Therefore, swallowing therapy targeting the pharyngeal phase is recommended after CCRT.
authors.affiliation: Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Sehi
authors.identifier: 0000-0002-8745-9927
authors.initials: S
authors.lastname: Kweon
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Bon Seok
authors.identifier: 0000-0003-3238-8719
authors.initials: BS
authors.lastname: Koo
authors.affiliation: Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Sungju
authors.identifier: 0000-0002-9400-9609
authors.initials: S
authors.lastname: Jee
keywords: Chemoradiotherapy; Deglutition disorders; Head and neck neoplasms