Pharyngeal transport dysfunction consequent to an organ-sparing protocol.

Area of Science:

• Oncology
• Radiology
• Swallowing Disorders

Background:

• Advanced head and neck cancer requires aggressive treatment.
• Organ-sparing protocols aim to minimize long-term side effects.
• Hydroxyurea and radiation therapy are common treatment modalities.

Purpose of the Study:

• To evaluate the impact of a combined hydroxyurea and hyperfractionated, accelerated, external-beam radiation therapy protocol on swallowing function.
• To identify specific swallowing abnormalities in patients with advanced head and neck cancer undergoing this treatment.

Main Methods:

• Videofluoroscopic swallow studies were performed post-treatment.
• Objective analysis of swallowing using the Kay Elemetrics Computerized Swallowing Station.
• Radiological descriptors and temporal measures assessed pharyngeal transport and structural movements.

Main Results:

• All 15 patients exhibited anterior pharyngeal segment dysfunction (e.g., no epiglottic movement, slowed laryngeal motility).
• 80% of patients showed posterior pharyngeal segment dysfunction (impaired pharyngeal constrictor motility).
• All patients had pharyngeal stage abnormalities limiting bolus transport and clearance.

Conclusions:

• The combined treatment protocol resulted in severe pharyngeal physiological abnormalities.
• These abnormalities frequently caused debilitating consequences for swallowing.
• Long-term follow-up is necessary to determine the persistence of these swallowing deficits.