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Swallow function in patients before and after intra-arterial chemoradiation
Darlene E Graner1, Robert L Foote, Jan L Kasperbauer
1Department of Neurology, Division of Radiation Oncology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. graner.darlene@mayo.edu
The Laryngoscope
|March 5, 2003
Summary
Advanced head and neck cancer treatment, including intra-arterial chemoradiation therapy and neck dissection, significantly impairs swallow function and increases aspiration risk in patients.
Area of Science:
- Oncology
- Otolaryngology
- Radiology
Background:
- Advanced head and neck cancer requires aggressive treatment.
- Intra-arterial chemoradiation therapy (IA-CRT) and neck dissection are common treatment modalities.
- Swallow dysfunction is a significant concern for patients undergoing these treatments.
Purpose of the Study:
- To prospectively evaluate changes in swallow function.
- To assess the impact of IA-CRT and neck dissection on swallowing.
- To analyze functional and quality of life outcomes post-treatment.
Main Methods:
- Prospective nonrandomized study of 11 patients with resectable T4/T3 head and neck cancer.
- Swallow function evaluated before and 19 weeks after IA-CRT and neck dissection.
- Utilized Performance Status Scale, videofluoroscopic swallow studies, and quality of life instruments.
Main Results:
- Worse scores in eating in public and normalcy of diet post-treatment.
- Neck dissection correlated with worse diet normalcy (P=.02).
- Increased aspiration incidence (3 to 7 patients) and worse videofluoroscopic findings post-treatment.
- Significant decline in swallowing measures (P=.02); no significant change in quality of life scores.
Conclusions:
- The majority of patients experience significantly worse swallow function 19 weeks post-treatment.
- IA-CRT and neck dissection lead to measurable declines in swallowing function.
- Continued monitoring of swallow function is critical for long-term management.