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Patient-reported outcomes following parotid-sparing intensity-modulated radiotherapy for head and neck cancer. How important is dysphagia?

Lookup NU author(s): Dr Michael DrinnanORCiD, Professor Paul Carding


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© 2014 Elsevier Ltd. Objectives: Swallowing can be significantly affected during and following radiotherapy for head and neck cancer (HNC). The purpose of this study was to understand: (1) the trajectory of swallowing recovery following parotid-sparing intensity-modulated radiotherapy (IMRT) and (2) overall physical and social-emotional wellbeing and how patients prioritise swallowing following treatment. Materials and methods: Sixty-one HNC patients completed questionnaires as part of a prospective study exploring patient-reported swallowing outcomes following parotid-sparing IMRT. Participants were asked to complete the M.D. Anderson Dysphagia Inventory (MDADI) and University of Washington Quality of Life Questionnaire (UW-QoL) v.04 before treatment and 3, 6 and 12 months after treatment. Given the rise in human papilloma virus (HPV) and associated oropharyngeal cancers, we completed a sub analysis of the data in those participants. Results: There was a significant reduction in the MDADI composite scores 3 months after completion of treatment. Improvements were observed by 12 months, however, scores did not recover to baseline. The recovery in physical function was limited in comparison to social-emotional recovery at 12 months. When oropharyngeal cancer scores were analysed, there was not a substantial difference to the whole group results. There was a shift in priorities following treatment. Swallowing was highlighted as a concern by 44% of HNC patients up to 12 months after treatment with swallowing-related factors (saliva, taste and chewing) rated highly. Conclusions: Patient reported swallowing outcomes were significantly affected from baseline to all follow-up time points and remained a priority concern at 12 months following treatment. Overall social-emotional functioning does improve, suggesting that patients have the potential to adapt to their "new normal" following IMRT for HNC.

Publication metadata

Author(s): Roe JWG, Drinnan MJ, Carding PN, Harrington KJ, Nutting CM

Publication type: Article

Publication status: Published

Journal: Oral Oncology

Year: 2014

Volume: 50

Issue: 12

Pages: 1182-1187

Print publication date: 01/12/2014

Online publication date: 14/10/2014

Acceptance date: 17/09/2014

ISSN (print): 1368-8375

ISSN (electronic): 1879-0593

Publisher: Elsevier Ltd


DOI: 10.1016/j.oraloncology.2014.09.009

PubMed id: 25448227


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