Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after...

Area of Science:

• Oncology
• Radiation Oncology
• Otorhinolaryngology

Background:

• Head and neck squamous cell carcinomas (HNSCCs) are often treated with radiotherapy (RT).
• Dysphagia is a common side effect impacting quality of life.
• Understanding long-term swallowing outcomes post-RT is crucial for patient care.

Purpose of the Study:

• To assess the impact of RT on dysphagia and long-term swallowing function in advanced HNSCC patients.
• To identify factors associated with post-treatment dysphagia.

Main Methods:

• Retrospective review of 189 patients with stage III-IV HNSCC treated with RT (2005-2008).
• Prospective evaluation of swallowing and dysphagia in 26 patients.
• Assessment of pre-treatment, post-treatment (3 months), and long-term (2019-2021) dysphagia.

Main Results:

• Pre-treatment dysphagia occurred in 48% of patients, especially with oropharyngeal/hypopharyngeal tumors.
• Post-treatment dysphagia was reported by 92% of patients, more frequent with positive neck nodes.
• Long-term dysphagia significantly improved, with rates dropping to 24%; linked to xerostomia, dysgeusia, and free flap reconstruction.

Conclusions:

• Pre-treatment dysphagia is prevalent in advanced HNSCC.
• Nearly all patients experience dysphagia immediately after RT.
• Long-term dysphagia significantly improves, independent of RT protocols, but is influenced by xerostomia, dysgeusia, and reconstruction methods.