Supported in part by NIH grant K23 DE 00459-2.
Swallow Function in Patients Before and After Intra-Arterial Chemoradiation†
Article first published online: 2 JAN 2009
Copyright © 2003 The Triological Society
Volume 113, Issue 3, pages 573–579, March 2003
How to Cite
Graner, D. E., Foote, R. L., Kasperbauer, J. L., Stoeckel, R. E., Okuno, S. H., Olsen, K. D., Sabri, A. N., Maragos, N. E., Cha, S. S., Sargent, D. J. and Strome, S. E. (2003), Swallow Function in Patients Before and After Intra-Arterial Chemoradiation. The Laryngoscope, 113: 573–579. doi: 10.1097/00005537-200303000-00033
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Manuscript Accepted: 23 OCT 2002
- organ preservation therapy;
- intra-arterial chemoradiation therapy;
- head and neck cancer
Objectives/Hypothesis To prospectively evaluate swallow function in patients with advanced head and neck cancer before and after completion of intra-arterial chemoradiation therapy and planned neck dissection.
Study Design Prospective nonrandomized study.
Methods Swallow function was evaluated in 11 patients with resectable T4 and selected T3 head and neck cancer before and, on average, 19 weeks after completion of treatment.
Results The Performance Status Scale demonstrated worse scores for both eating in public (P = .004) and normalcy of diet (P = .004) after treatment. Patients who underwent neck dissections had significantly worse scores (P = .02) in normalcy of diet. A significant decline was noted in swallowing functional measures at the time of the repeat evaluation (P = .02). Videofluoroscopic swallow studies revealed altered swallow function in 9 of 11 patients before treatment, with aspiration seen in 3 patients. Following treatment, the incidence of aspiration increased to seven patients. Tongue base retraction, reduced laryngeal elevation, and increased laryngeal vestibule penetration of thick liquid were all statistically significantly worse after treatment. The overall score on the quality of life instrument was not significantly changed from before to after treatment.
Conclusions The majority of patients demonstrated significantly worse swallow function on all three methods of analysis at 19 weeks after completion of treatment. Continued detailed monitoring of patients' swallow function is critical in determining long-term effects of intra-arterial chemoradiation therapy and neck dissection.