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Dysphagia severity following chemoradiation and postoperative radiation for head and neck cancer.
- Source :
-
European journal of radiology [Eur J Radiol] 2006 Sep; Vol. 59 (3), pp. 453-9. Date of Electronic Publication: 2006 May 09. - Publication Year :
- 2006
-
Abstract
- Objective: The purpose of the study is to evaluate dysphagia severity following chemoradiation and postoperative radiation for head and neck cancer, and particularly the aspiration risk because of its potential life-threatening consequence.<br />Materials and Methods: We reviewed retrospectively the modified barium swallow (MBS) results in 110 patients who complained of dysphagia following chemoradiation (57) and postoperative radiation (53) of their head and neck cancer. Patients were selected if they were cancer free at the time of the swallowing study. Dysphagia severity was graded on a scale of 1-7. Patients were grouped according to the dysphagia severity: mild (grades 2-3), moderate (grades 4-5), and severe (grades 6-7).<br />Results: Mean and median dysphagia grades were 4.84/5 and 4.12/4 for chemoradiation and postoperative radiation respectively. The mean difference between the two groups is statistically significant (p=0.02). Mild dysphagia occurred in 13 patients (22%) of the chemoradiation group and 17 (32%) of the postoperative group. Corresponding number for the moderate group was 25 (43%) and 25 (48%), respectively. Severe dysphagia was significant in the chemoradiation group (34%) compared to the postoperative group (19%). However, the difference was not statistically significant (p=0.29). There was a higher proportion of patients with large tumor (T3-T4) in the chemoradiation group who developed severe dysphagia.<br />Conclusion: Dysphagia remained a significant morbidity of chemoradiation and postoperative radiation for head and neck cancer. Dysphagia may be more severe in the chemoradiation group because of the higher proportion of patients with large tumor, the high radiation dose, and a high number of oropharyngeal tumors. Aspiration occurred in both groups. Diagnostic studies such as MBS should be part of future head and neck cancer prospective studies to assess the prevalence of aspiration, as it may be silent.
- Subjects :
- Aged
Aged, 80 and over
Barium Sulfate administration & dosage
Combined Modality Therapy
Deglutition
Deglutition Disorders physiopathology
Female
Head and Neck Neoplasms drug therapy
Head and Neck Neoplasms surgery
Humans
Male
Middle Aged
Postoperative Period
Retrospective Studies
Severity of Illness Index
Deglutition Disorders etiology
Head and Neck Neoplasms radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 0720-048X
- Volume :
- 59
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of radiology
- Publication Type :
- Academic Journal
- Accession number :
- 16687229
- Full Text :
- https://doi.org/10.1016/j.ejrad.2006.03.019