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. 2022 Feb;279(2):995-1001.
doi: 10.1007/s00405-021-06861-y. Epub 2021 May 7.

Asymptomatic swallowing disorders may be present in individuals with laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy

César Álvarez-Marcos  1   2   3   4 , Andrea Vicente Benito  5 , Agueda Gayol Fernández  5 , Daniel Pedregal-Mallo  1   2   3 , Paloma Sirgo Rodríguez  5 , Liliana Santamarina Rabanal  5 , José Luis Llorente  1   2   3   4 , Fernando López  6   7   8   9 , Juan Pablo Rodrigo  1   2   3   4
Affiliations

Asymptomatic swallowing disorders may be present in individuals with laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy

César Álvarez-Marcos et al. Eur Arch Otorhinolaryngol. 2022 Feb.

Abstract

Purpose: Patients with advanced laryngeal and hypopharyngeal cancer are often treated with chemo-radiotherapy to avoid total laryngectomy. Subclinical swallowing disorders could be present in these patients even though patients do not complain of any symptoms. We sought to evaluate the impact of chemoradiation on swallowing and quality of life.

Methods: We studied 21 patients undergoing chemo-radiotherapy for advanced laryngeal and hypopharyngeal cancer. All patients were tumor-free and none reported symptoms related to dysphagia during follow-up or showed altered routine screening tests (EAT-10) to detect it. Swallowing functions were assessed using volume-viscosity swallow test (V-VST) and fiberoptic endoscopic evaluation of swallowing (FEES). Quality of life was assessed with the EORT-H&N35, and SWAL-QOL scales.

Results: Frequent alterations in swallowing efficacy (100%) and safety (85.5%) were detected with V-VST and FEES. Quality-of-life scales showed a reduction in their scores between 12 and 17%, mainly in the areas of symptoms.

Conclusion: Swallowing disorders are common after chemo-radiotherapy, even in patients who do not clinically manifest these disorders, contributing to a decrease in patients' quality of life. FEES and V-VST are useful procedures to detect asymptomatic swallowing disorders.

Keywords: Chemo-radiotherapy; Laryngeal and hypopharyngeal cancer; Quality of life; Swallowing.

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