Site of disease and treatment protocol as correlates of swallowing function in patients with head and neck cancer treated with chemoradiation

Background. The relationship between type of chemoradiation treatment, site of disease, and swallowing function has not been sufficiently examined in patients with head and neck cancer treated primarily with chemoradiation. Methods. Fifty-three patients with advanced-stage head and neck cancer were evaluated before and 3 months after chemoradiation treatment to define their swallowing disorders and characterize their swallowing physiology by site of lesion and chemoradiation protocol. One hundred forty normal subjects were also studied. Results. The most common disorders at baseline and 3 months after treatment were reduced tongue base retraction, reduced tongue strength, and slowed or delayed laryngeal vestibule closure. Frequency of functional swallow did not differ significantly across disease sites after treatment, although frequency of disorders was different at various sites of lesion. The effects of the chemotherapy protocols were small. Conclusions. The site of the lesion affects the frequency of occurrence of specific swallow disorders, whereas chemo-radiation protocols have minimal effect on oropharyngeal swallow function.