1. Risk of aspiration following radiation for non-nasopharyngeal head and neck cancer.
- Author
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Nguyen NP, Frank C, Moltz CC, Millar C, Vos P, Smith HJ, Dutta S, Karlsson U, Nguyen PD, Nguyen LM, Lemanski C, and Sallah S
- Subjects
- Aged, Aged, 80 and over, Carcinoma, Squamous Cell pathology, Cross-Sectional Studies, Deglutition Disorders epidemiology, Deglutition Disorders etiology, Dose Fractionation, Radiation, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Pneumonia, Aspiration epidemiology, Radiation Injuries epidemiology, Radiotherapy Dosage, Retrospective Studies, Texas, Carcinoma, Squamous Cell radiotherapy, Otorhinolaryngologic Neoplasms radiotherapy, Pneumonia, Aspiration etiology, Radiation Injuries etiology
- Abstract
Objective: We assessed the rate of aspiration following radiation for non-nasopharyngeal head and neck cancer., Design: Retrospective study., Setting: Veterans Administration Hospital., Patients: Thirty-three patients who underwent radiation for head and neck cancer. Modified barium swallow was performed prior to and following treatment to assess the persistence of dysphagia and aspiration risk. All patients were cancer free at the time of the swallowing study. Dysphagia severity was graded from 1 to 7., Results: Preradiation baseline dysphagia was observed as follows: 10 grade 1, 14 grade 2, 9 grade 3, and 1 grade 4. Following radiation, at a median follow-up of 3 months, nine patients had grade 1, eight patients had grade 2, six patients had grade 3, two patients had grade 4, three patients had grade 5, two patients had grade 6, and three patients had grade 7. Overall, 24% (8 of 33) of the patients developed aspiration (grades 5-7). Fifteen percent (5 of 33) of the patients had severe aspiration (grades 6-7) requiring tube feedings. All patients who developed severe aspiration continued to require tube feedings more than 1 year following treatment completion., Conclusion: Aspiration is a significant source of morbidity following radiation for non-nasopharyngeal head and neck cancer. Aspiration may develop for all tumour stages or sites. Diagnostic studies such as modified barium swallow should be included in future prospective head and neck cancer studies to assess the prevalence of aspiration because of its often silent nature.
- Published
- 2008