Effect of Induction Chemotherapy on Swallowing in Head and Neck Cancer Patients

Objective: To evaluate the effect of induction chemotherapy on swallowing and swallowing-related quality of life of patients with oropharyngeal, laryngeal and hypopharyngeal cancer. Study design: Prospective study of 33 patients with locally advanced tumors who were eligible for treatment with neoadjuvant chemotherapy followed by radiotherapy and concurrent chemotherapy. A multidimensional assessment of swallowing was performed using the following tools: (1) Clinical analysis, numerical scale for general pain and painful swallowing, American Speech and Hearing Association (ASHA) Functional Communication Measures (FCM) swallowing assessment scales, (2) assessment of Swallowing-Related Quality of Life (The MD Anderson Dysphagia Inventory - MDADI), and (3) swallowing videofluoroscopy. Results: There was a reduction in general pain scale (p=0.021), and quality of life (emotional, functional and physical) improved from average limitation (score of 61-80) to minimal limitation (81-100) after induction chemotherapy. According to the swallowing videofluoroscopy results, 26 (78.7%) of the patients had some degree of dysphagia pre-treatment, which decreased to 21 (63.6%) after induction. Conclusion: Our results suggest that induction chemotherapy improves numerous aspects of swallowing and has a positive impact on the quality of life of pre-chemoradiotherapy patients.

[1]  I. Helenowski,et al.  Effect of induction chemotherapy on swallow physiology and saliva production in patients with head and neck cancer: A pilot study , 2015, Head & neck.

[2]  A. Garden.  The never-ending story: finding a role for neoadjuvant chemotherapy in the management of head and neck cancer. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  T. McNutt,et al.  Effect of Gabapentin on Swallowing During and After Chemoradiation for Oropharyngeal Squamous Cell Cancer , 2014, Dysphagia.

[4]  D. Chhetri,et al.  Swallow Preservation Exercises during Chemoradiation Therapy Maintains Swallow Function , 2013, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[5]  Amy Y. Chen,et al.  Validation and Application of the M.D. Anderson Dysphagia Inventory in Patients Treated for Head and Neck Cancer in Brazil , 2013, Dysphagia.

[6]  Annemieke H Ackerstaff,et al.  Pretreatment organ function in patients with advanced head and neck cancer: clinical outcome measures and patients' views , 2009, BMC ear, nose, and throat disorders.

[7]  S. Spencer,et al.  Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cancer. , 2009, International journal of radiation oncology, biology, physics.

[8]  J. Parsons,et al.  Neoadjuvant chemotherapy followed by concurrent hyperfractionated radiation therapy and sensitizing chemotherapy for locally advanced (T3–T4) oropharyngeal squamous cell carcinoma , 2009, Head & neck.

[9]  E. Vokes,et al.  Characteristics associated with swallowing changes after concurrent chemotherapy and radiotherapy in patients with head and neck cancer. , 2008, Archives of otolaryngology--head & neck surgery.

[10]  Suzanne L Wolden,et al.  Concurrent cetuximab, cisplatin, and concomitant boost radiotherapy for locoregionally advanced, squamous cell head and neck cancer: a pilot phase II study of a new combined-modality paradigm. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  B. Gustafsson,et al.  Dysphagia, an unrecognized handicap , 2006, Dysphagia.

[12]  L. Wilson,et al.  Nutritional support of patients undergoing radiation therapy for head and neck cancer. , 2005, Oncology.

[13]  M. B. Gillespie,et al.  Swallowing‐Related Quality of Life After Head and Neck Cancer Treatment , 2004, The Laryngoscope.

[14]  Ellen B. Roecker,et al.  A penetration-aspiration scale , 2004, Dysphagia.

[15]  S. Rogers,et al.  Importance-rating using the University of Washington quality of life questionnaire in patients treated by primary surgery for oral and oro-pharyngeal cancer. , 2002, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[16]  C. McHorney,et al.  The SWAL–QOL and SWAL–CARE Outcomes Tool for Oropharyngeal Dysphagia in Adults: III. Documentation of Reliability and Validity , 2002, Dysphagia.

[17]  R. Frankowski,et al.  The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. , 2001, Archives of otolaryngology--head & neck surgery.

[18]  J. Pignon,et al.  Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta analysis of chemotherapy on head and neck cancer , 2001 .

[19]  J. Bourhis,et al.  Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data , 2000, The Lancet.

[20]  V. Garabige,et al.  Bonnes pratiques pour la prise en charge diététique des patients atteints de cancer des voies aérodigestives supérieures , 1999 .

[21]  Karen H. O'Neil,et al.  The Dysphagia Outcome and Severity Scale , 1999, Dysphagia.

[22]  J. Irwin.  American Speech and Hearing Association. , 1969, ASHA.