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Swallowing beyond six years post (chemo)radiotherapy for head and neck cancer; a cohort study

Lookup NU author(s): Dr Joanne Patterson, Emerita Professor Elaine McCollORCiD, Professor Paul Carding, Emerita Professor Janet WilsonORCiD


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© 2018 Elsevier Ltd Objective: The objective of this prospective study is to report on long-term swallowing outcomes in a group of head and neck cancer patients following (chemo) radiotherapy treatment, assess for changes over time and identify any predictor variables of outcome. Materials and methods: 42 survivors were assessed on four swallowing measures and followed up from pre-treatment to six years post 3D (chemo) radiotherapy. Measures included a swallowing specific QOL questionnaire, penetration-aspiration scale, dietary restrictions and a timed water swallow test. Results: At six years, 71% reported swallowing difficulties on the questionnaire. One fifth of patients had aspiration, with a raised risk of chest infection. Seven percent required a laryngectomy for a dysfunctional larynx. Despite this, half the group reported having a normal diet. There was variation in the pattern of change between one and six years. A significant deterioration was only observed in the timed water swallow test (p < 0.0001). Larger radiotherapy volume predicted this outcome. None of the variables tested predicted outcome for the other three swallow measures. Conclusion: Patients continue to report swallowing difficulties at six years, with a proportion having persistent aspiration. Further work on identifying the risk factors associated with aspiration tolerance, aspiration pneumonia, prevention and management is warranted. Long-term dysphagia remains a significant and serious concern following (chemo) radiotherapy for HNC and swallowing outcomes should continue to be monitored over time.

Publication metadata

Author(s): Patterson JM, McColl E, Carding PN, Wilson JA

Publication type: Article

Publication status: Published

Journal: Oral Oncology

Year: 2018

Volume: 83

Pages: 53-58

Print publication date: 01/08/2018

Online publication date: 12/06/2018

Acceptance date: 01/06/2018

ISSN (print): 1368-8375

ISSN (electronic): 1879-0593

Publisher: Elsevier Ltd


DOI: 10.1016/j.oraloncology.2018.06.003


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