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. 2021 Feb;29(2):955-964.
doi: 10.1007/s00520-020-05570-2. Epub 2020 Jun 16.

Simultaneous evaluation of symptoms, swallowing functions, and patient-reported swallowing difficulties and their correlations with ingestion status during definitive chemoradiotherapy for oropharyngeal and hypopharyngeal cancer

Ryo Ishii  1 , Kengo Kato  2 , Akira Ohkoshi  2 , Takeshi Sato  2 , Ai Hirano  2 , Takenori Ogawa  2 , Yukio Katori  2
Affiliations

Simultaneous evaluation of symptoms, swallowing functions, and patient-reported swallowing difficulties and their correlations with ingestion status during definitive chemoradiotherapy for oropharyngeal and hypopharyngeal cancer

Ryo Ishii et al. Support Care Cancer. 2021 Feb.

Abstract

Purpose: To clarify the correlations among symptoms, swallowing functions, and ingestion status and to validate a method of swallowing evaluation during chemoradiotherapy (CRT) for head and neck cancer.

Methods: Oropharyngeal and hypopharyngeal cancer patients who were to receive definitive CRT as initial treatment were included in this prospective, single-center, observational study. The Functional Oral Intake Scale (FOIS) for ingestion status and grades of symptoms (dryness, dysgeusia, mucositis, and the analgesic ladder); the Yale Pharyngeal Residue Severity Rating Scale on fiberoptic endoscopic evaluation of swallowing (FEES) and the Penetration-Aspiration Scale (PAS) on videofluoroscopic (VF) evaluation for swallowing functions; and the 10-item Eating Assessment Tool (EAT-10) questionnaire were assessed at 5 time points unless the participant refused. The FEES and VF evaluation findings at each point were also compared.

Results: There were 38 participants. Dysgeusia, mucositis, and pain grade, as well as the FOIS score, were the worst at 70 Gy and then improved after treatment. The improvements of pharyngeal residue and the PAS after treatment were limited. The EAT-10 and the pain ladder were highly correlated with the FOIS changes at many time points. The VF evaluation rate dropped after 40 Gy, whereas the FEES rate remained high. There were good correlations between pharyngeal residue and the PAS at 0 Gy, 70 Gy, and 3 months.

Conclusion: The EAT-10 and pain reflected the FOIS score changes well, while two swallowing evaluations did not. To avoid aspiration, VF evaluation may not be necessary during CRT because of high correlations with pharyngeal residue on FEES.

Keywords: Chemoradiotherapy; Head and neck cancer; Ingestion status; Swallowing difficulties; Swallowing evaluation.

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References

    1. Newman LA, Vieira F, Schwiezer V, Samant S, Murry T, Woodson G, Kumar P, Robbins KT (1998) Eating and weight changes following chemoradiation therapy of advanced head and neck cancer. Arch Otolaryngel Head Neck Surg 124:589–592. https://doi.org/10.1001/archotol.124.5.589 - DOI
    1. Eisbruch A, Lyden T, Bradford CR, Dawson LA, Haxer MJ, Miller AE, Teknos TN, Chepeha DB, Hogikyan ND, Terrell JE, Wolf GT (2002) Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head-and-neck cancer. Int J Radiat Oncol Biol Phys 53:23–28. https://doi.org/10.1016/s0360-3016(02)02712-8 - DOI - PubMed
    1. Eisbruch A, Schwartz M, Rasch C, Vineberg K, Damen E, Van As CJ, Marsh R, Pameijer FA, Balm AJ (2004) Dysphagia and aspiration after chemoradiotherapy for head-and-neck cancer: which anatomic structures are affected and can be spared by IMRT? Int J Radiat Oncol Biol Phys 60:1425–1439. https://doi.org/10.1016/j.ijrobp.2004.05.050 - DOI - PubMed
    1. Logemann JA, Pauloski BR, Rademaker AW, Colangelo LA (1997) Speech and swallowing rehabilitation for head and neck cancer patients. Oncology (Williston Park) 11:651–6, 659
    1. Carroll WR, Locher JL, Canon CL, Bohannon IA, McColloch NL, Magnuson JS (2008) Pretreatment swallowing exercises improve swallow function after chemoradiation. Laryngoscope 118:39–43. https://doi.org/10.1097/MLG.0b013e31815659b0 - DOI - PubMed

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