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. 2022 Nov;30(11):9527-9538.
doi: 10.1007/s00520-022-07322-w. Epub 2022 Aug 30.

The course of swallowing problems in the first 2 years after diagnosis of head and neck cancer

Jorine A Vermaire  1 , Cornelis P J Raaijmakers  1 , Evelyn M Monninkhof  2 , C René Leemans  3 , Robert J Baatenburg de Jong  4 , Robert P Takes  5 , Irma M Verdonck-de Leeuw  3   6 , Femke Jansen  3 , Johannes A Langendijk  7 , Chris H J Terhaard  1 , Caroline M Speksnijder  8   9
Affiliations

The course of swallowing problems in the first 2 years after diagnosis of head and neck cancer

Jorine A Vermaire et al. Support Care Cancer. 2022 Nov.

Erratum in

Abstract

Introduction: Head and neck cancer (HNC) and its treatment often negatively impact swallowing function. The aim was to investigate the course of patient-reported swallowing problems from diagnosis to 3, 6, 12, and 24 months after treatment, in relation to demographic, clinical, and lifestyle factors.

Methods: Data were used of the Netherlands Quality of Life and Biomedical Cohort Study in head and neck cancer research (NET-QUBIC). The primary outcome measures were the subscales of the Swallowing Quality of Life Questionnaire (SWAL-QOL). Linear mixed-effects models (LMM) were conducted to investigate changes over time and associations with patient, clinical, and lifestyle parameters as assessed at baseline.

Results: Data were available of 603 patients. There was a significant change over time on all subscales. Before treatment, 53% of patients reported swallowing problems. This number increased to 70% at M3 and decreased to 59% at M6, 50% at M12, and 48% at M24. Swallowing problems (i.e., longer eating duration) were more pronounced in the case of female, current smoking, weight loss prior to treatment, and stage III or IV tumor, and were more prevalent at 3 to 6 months after treatment. Especially patients with an oropharynx and oral cavity tumor, and patients receiving (C)RT following surgery or CRT only showed a longer eating duration after treatment, which did not return to baseline levels.

Conclusion: Half of the patients with HNC report swallowing problems before treatment. Eating duration was associated with sex, smoking, weight loss, tumor site and stage, and treatment modality, and was more pronounced 3 to 6 months after treatment.

Keywords: Head and neck cancer; Linear mixed-effects model; Oral function; SWAL-QOL; Swallowing.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart depicting the number of patients at each time point. *Missing measurement
Fig. 2
Fig. 2
Mean scores of the SWAL-QOL total score and subscales with standard error from baseline (M0) up to 2 years (M24) after treatment in patients with head and neck cancer. *p < 0.05 in comparison to baseline. SWAL-QOL, Quality of Life in Swallowing Disorders questionnaire
Fig. 3
Fig. 3
The mean outcomes for eating duration based on tumor site (A) and treatment modality (B) to provide insight in the raw and modeled data. The solid lines represent the linear mixed model outcomes of the final model; the striped lines represent the raw data. CRT, chemoradiation; RT, radiotherapy
See this image and copyright information in PMC

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