Site of disease and treatment protocol as correlates of swallowing function in patients with head and neck cancer treated with chemoradiation

Authors

  • Jeri A. Logemann PhD,

    Corresponding author
    1. Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, Evanston, IL 60208
    2. Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago and Evanston, Illinois
    • Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, Evanston, IL 60208
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  • Alfred W. Rademaker PhD,

    1. Department of Preventive Medicine, Northwestern University, Chicago, Illinois
    2. Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago and Evanston, Illinois
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  • Barbara Roa Pauloski PhD,

    1. Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Drive, Evanston, IL 60208
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  • Cathy L. Lazarus PhD,

    1. Department of Otolaryngology, New York University School of Medicine, New York, New York
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  • Bharat B. Mittal MD,

    1. Division of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • Bruce Brockstein MD,

    1. Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago and Evanston, Illinois
    2. Department of Hematology Oncology, Evanston Northwestern Healthcare, Evanston, Illinois
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  • Ellen MacCracken MS,

    1. Division of Hematology/Oncology and Departments of Radiation Oncology and Otolaryngology–Head and Neck Surgery and the Comprehensive Cancer Center, University of Chicago, Chicago, Illinois
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  • Daniel J. Haraf MD,

    1. Division of Hematology/Oncology and Departments of Radiation Oncology and Otolaryngology–Head and Neck Surgery and the Comprehensive Cancer Center, University of Chicago, Chicago, Illinois
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  • Everett E. Vokes MD,

    1. Division of Hematology/Oncology and Departments of Radiation Oncology and Otolaryngology–Head and Neck Surgery and the Comprehensive Cancer Center, University of Chicago, Chicago, Illinois
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  • Lisa A. Newman ScD,

    1. Audiology and Speech Center, Walter Reed Army Medical Center, Washington, D.C.
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  • Dachao Liu MS

    1. Department of Preventive Medicine, Northwestern University, Chicago, Illinois
    2. Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago and Evanston, Illinois
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Abstract

Background.

The relationship between type of chemoradiation treatment, site of disease, and swallowing function has not been sufficiently examined in patients with head and neck cancer treated primarily with chemoradiation.

Methods.

Fifty-three patients with advanced-stage head and neck cancer were evaluated before and 3 months after chemoradiation treatment to define their swallowing disorders and characterize their swallowing physiology by site of lesion and chemoradiation protocol. One hundred forty normal subjects were also studied.

Results.

The most common disorders at baseline and 3 months after treatment were reduced tongue base retraction, reduced tongue strength, and slowed or delayed laryngeal vestibule closure. Frequency of functional swallow did not differ significantly across disease sites after treatment, although frequency of disorders was different at various sites of lesion. The effects of the chemotherapy protocols were small.

Conclusions.

The site of the lesion affects the frequency of occurrence of specific swallow disorders, whereas chemoradiation protocols have minimal effect on oropharyngeal swallow function. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX–XXX, 2005

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