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Functional outcomes following chemoradiotherapy for head and neck cancer
Lee M Akst1, James Chan, Paul Elson
1Department of Otolaryngology and Communicative Disorders, The Cleveland Clinic Foundation, Ohio 44195, USA. AKSTL@ccf.org
Objective:
To study functional outcomes following concurrent chemoradiotherapy of head and neck cancer.
Methods:
A retrospective chart review assessed diet, feeding tube use, and tracheotomy pretreatment and 3, 6, 12, and 24 months posttreatment.
Results:
Of 196 patients who underwent chemoradiotherapy between 1990 and 2002, 148 (76%) required feeding tubes immediately posttreatment; 150 (77%) required nutritional support at 3 months. By 12 months, 92% were tube-free and 83% resumed near-normal diet. Of 17 patients (9%) with tracheotomy posttreatment, 71% were decannulated by 6 months. Stage IV disease strongly predicted prolonged feeding tube use and slow recovery of diet; age > or =60 also predicted slow recovery. Primary site, gender, and radiotherapy schedule did not predict functional recovery after adjusting for stage and age.
Conclusion:
Few patients required tracheotomy before or during chemoradiotherapy. Many patients required feeding tubes and nutritional support for several months following therapy, but most were tube-free and eating near-normal diets within 1 year.
Ebm Rating:
C.
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