Post-Radiotherapy Dysphagia in Head and Neck Cancer: Current Management by Speech-Language Pathologists

Area of Science:

• Oncology
• Radiotherapy
• Speech-Language Pathology

Background:

• Dysphagia is a prevalent and severe side effect of head and neck cancer (HNC) radiotherapy, impacting patient function and quality of life (QOL).
• Improved survival rates in HNC, particularly for HPV-related cancers, mean more patients live longer with treatment sequelae, including persistent or new-onset dysphagia.
• Speech-language pathology (SLP) is crucial for managing dysphagia post-HNC radiotherapy, addressing both acute and long-term effects.

Purpose of the Study:

• To review current SLP management strategies for dysphagia following HNC radiotherapy.
• To discuss conventional treatments, emerging therapy adjuncts, and service delivery models.
• To highlight the need for further research into optimizing dysphagia interventions.

Main Methods:

• Review of current SLP practices for head and neck cancer dysphagia.
• Discussion of conventional and emerging therapeutic approaches.
• Analysis of service delivery models and adherence impact.

Main Results:

• Despite advancements, many patients experience dysphagia resistant to current interventions.
• Significant variation exists in treatment programs, with limited evidence supporting optimal approaches.
• Adherence to therapy is a key factor influencing outcomes.

Conclusions:

• Further research is essential to improve dysphagia management post-radiotherapy.
• Areas for investigation include radiotherapy's impact on the central nervous system, sarcopenia's role, and visual biofeedback benefits.
• Optimizing the type, timing, and intensity of dysphagia interventions is critical for improving patient QOL.