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  • Title: Swallowing-related quality of life after head and neck cancer treatment.
    Author: Gillespie MB, Brodsky MB, Day TA, Lee FS, Martin-Harris B.
    Journal: Laryngoscope; 2004 Aug; 114(8):1362-7. PubMed ID: 15280708.
    Abstract:
    OBJECTIVES: To determine the role of treatment modality in swallowing outcome after head and neck cancer treatment and to identify potential risk factors for posttreatment dysphagia. STUDY DESIGN: Cross-sectional survey of patients with no evidence of disease 12 months or more after the treatment of a stage III or IV squamous cell carcinoma of the oropharynx, larynx, or hypopharynx. METHODS: Potential subjects were stratified by tumor site and tumor T-stage to achieve a balanced comparison between chemoradiation (n = 18) and surgery/radiation (n = 22) groups. Outcome measures included a dysphagia risk factor survey, the MD Anderson Dysphagia Inventory (MDADI), and the Short-Form 36 (SF-36). RESULTS: Patients who received chemoradiation for oropharyngeal primaries demonstrated significantly better scores on the emotional (P =.03) and functional (P =.02) subscales of the MDADI than did patients who underwent surgery followed by radiation. There were no significant differences between chemoradiation and surgery/radiation groups for laryngeal and hypopharyngeal primaries. Additional risk factors for posttreatment dysphagia include prolonged (>2 weeks) nothing by mouth (NPO) status (P =.002) and low SF-36 Mental Health Subscale score (P =.002). CONCLUSION: The study suggests that chemoradiation may provide superior swallowing outcome to surgery/radiation in patients with oropharyngeal primary. Patients with depressed mental health and prolonged feeding tubes may be at higher risk of long-term dysphagia.
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