A swallow preservation protocol improves function for veterans receiving chemoradiation for head and neck cancer

Area of Science:

• Oncology
• Otolaryngology
• Rehabilitation Medicine

Background:

• Head and neck squamous cell carcinoma (HNSCC) treatment often involves chemoradiation (CRT) or radiation therapy (RT), potentially causing significant dysphagia.
• Swallowing dysfunction can negatively impact quality of life and nutritional status in HNSCC patients.
• Early intervention strategies are needed to mitigate treatment-related swallowing complications.

Purpose of the Study:

• To evaluate the efficacy of a swallow preservation protocol (SPP) in maintaining swallowing function.
• To compare swallowing outcomes in HNSCC patients who received SPP versus those who did not during CRT or RT.

Main Methods:

• Retrospective case series conducted at a Veterans Affairs medical center.
• Patients with HNSCC treated with CRT or RT between 2006 and 2013 were analyzed.
• The SPP group performed swallowing, jaw, and tongue exercises; the comparator group received no swallowing intervention. Dysphagia was quantified using the functional outcome swallowing scale (FOSS).

Main Results:

• Forty-one patients in the SPP group and 66 in the comparator group were included.
• The SPP group maintained a mean FOSS score of 2.2 pre- and post-treatment.
• The comparator group showed a significant worsening of mean FOSS scores from 1.8 pre-treatment to 2.7 post-treatment.

Conclusions:

• The SPP was effective in preserving swallowing function during cancer therapy for HNSCC.
• Early evaluation and intervention for dysphagia are critical for patients undergoing CRT or RT.
• This study highlights the importance of proactive swallowing rehabilitation in head and neck cancer care.