Swallowing-related quality of life after head and neck cancer treatment

M. Boyd Gillespie*, Martin B. Brodsky, Terry A. Day, Fu Shing Lee, Bonnie Martin-Harris

*Corresponding author for this work

Research output: Contribution to journalArticle

163 Scopus citations

Abstract

Objectives: To determine the role of treatment modality in swallowing outcome after head and neck cancer treatment and to identify potential risk factors for posttreatment dysphagia. Study Design: Cross-sectional survey of patients with no evidence of disease 12 months or more after the treatment of a stage III or IV squamous cell carcinoma of the oropharynx, larynx, or hypopharynx. Methods: Potential subjects were stratified by tumor site and tumor T-stage to achieve a balanced comparison between chemoradiation (n = 18) and surgery/radiation (n = 22) groups. Outcome measures included a dysphagia risk factor survey, the MD Anderson Dysphagia Inventory (MDADI), and the Short-Form 36 (SF-36). Results: Patients who received chemoradiation for oropharyngeal primaries demonstrated significantly better scores on the emotional (P =. 03) and functional (P =. 02) subscales of the MDADI than did patients who underwent surgery followed by radiation. There were no significant differences between chemoradiation and surgery/radiation groups for laryngeal and hypopharyngeal primaries. Additional risk factors for posttreatment dysphagia include prolonged (>2 weeks) nothing by mouth (NPO) status (P =. 002) and low SF-36 Mental Health Subscale score (P =. 002). Conclusion: The study suggests that chemoradiation may provide superior swallowing outcome to surgery/radiation in patients with oropharyngeal primary. Patients with depressed mental health and prolonged feeding tubes may be at higher risk of long-term dysphagia.

Original languageEnglish (US)
Pages (from-to)1362-1367
Number of pages6
JournalLaryngoscope
Volume114
Issue number8
DOIs
StatePublished - Aug 2004

Keywords

  • Dysphagia
  • MD Anderson Dysphagia Inventory
  • chemoradiation
  • outcomes
  • squamous cell carcinoma
  • swallowing

ASJC Scopus subject areas

  • Otorhinolaryngology

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