Analysis of dysphagia in advanced-stage head-and-neck cancer patients: impact on quality of life and development of a preventive swallowing treatment

Carmignani, Ilaria; Locatello, Luca Giovanni; Desideri, Isacco; Bonomo, Pierluigi; Olmetto, Emanuela; Livi, Lorenzo; Saec, Odile Le; Coscarelli, Salvatore; Mannelli, Giuditta

doi:10.1007/s00405-018-5054-9

Cited by 66 publications

(63 citation statements)

References 35 publications

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“…Carmignani et al found better post-therapy swallowing function in patients with hypopharynx or larynx cancer as compared to oral cavity and OPC. 49 The current study was not able to show any difference in dysphagia determined by the tumor site. Increasing T classification, on the other hand, seemed to correlate with dysphagia severity.…”

Section: Discussioncontrasting

confidence: 72%

Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

et al. 2019

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Background Acute and late toxicity after intensity‐modulated radiotherapy (IMRT) for head and neck cancer (HNC) impacts on patient quality of life; yet, very late toxicity data remain scarce. This study assessed dysphagia, xerostomia, and neck fibrosis 3‐8 years after IMRT. Methods A retrospective analysis using generalized estimated equations was performed on 60 patients with HNC treated with fractionated IMRT between 2000 and 2015 who had a follow‐up ≥8 years. Toxicity was scored using LENT‐SOMA scales. Results A trend towards a nonlinear global time effect (P = .05) was noted for dysphagia with a decrease during the 5 years post‐treatment and an increase thereafter. A significant decrease in xerostomia (P = .001) and an increase in neck fibrosis (P = .04) was observed until 8 years. Conclusions Dysphagia, xerostomia, and neck fibrosis do not appear stable over time and remain highly prevalent in the very late follow‐up. Our findings support the need for prospective trials investigating very late toxicity in patients with HNC.

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Section: Discussioncontrasting

confidence: 72%

Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

et al. 2019

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“…Dysphagia is an important cause of malnutrition, dehydration, weight loss, chronic aspiration and aspiration pneumonia. All these complications can lead to not only serious health issues and even death, but may also result in depression and social isolation 8, 9, 10, 11, 12, 13, 14, 15. In addition, late dysphagia, even of a mild grade, is one of the most important factors adversely influencing quality of life of HNC patients, with feeding-tube dependency having the most negative impact 9…”

Section: Introductionmentioning

confidence: 99%

Swallowing disorders after treatment for head and neck cancer

Pezdirec

Strojan

Boltežar

2019

Radiology and Oncology

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Background Dysphagia is a common consequence of treatment for head and neck cancer (HNC). The purpose of the study was to evaluate the prevalence of dysphagia in a group of patients treated for HNC in Slovenia, and to identify factors contributing to the development of dysphagia. Patients and methods One-hundred-nine consecutive patients treated for HNC at two tertiary centers were recruited during their follow-up visits. They fulfilled EORTC QLQ-H&N35 and “Swallowing Disorders after Head and Neck Cancer Treatment questionnaire” questionnaires. Patients with dysphagia were compared to those without it. Results Problems with swallowing were identified in 41.3% of the patients. Dysphagia affected their social life (in 75.6%), especially eating in public (in 80%). Dysphagia was found the most often in the patients with oral cavity and/or oropharyngeal cancer (in 57.6%) and in those treated less than 2 years ago (p = 0.014). In univariate analysis, a significant relationship was observed between dysphagia prevalence and some of the consequences of anti-cancer treatment (impaired mouth opening, sticky saliva, loss of smell, impaired taste, oral and throat pain, persistent cough, and hoarseness), radiotherapy (p = 0.003), and symptoms of gastroesophageal reflux (p = 0.027). After multiple regression modelling only persistent cough remained. Conclusions In order to improve swallowing abilities and, consequently, quality of life of the patients with HNC a systematic rehabilitation of swallowing should be organized. A special emphasis should be given to gastroesophageal reflux treatment before, during and after therapy for HNC

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“…Twenty-one of these studies were prospective studies [ 14 – 34 ] and eight were retrospective [ 35 – 42 ]. The sample sizes ranged from twelve [ 30 ] to 497 participants [ 42 ]. The majority of the sample sizes were small, with 18 studies including 60 or fewer participants [ 15 – 25 , 27 , 28 , 30 , 33 – 35 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…All studies were based on patients undergoing radiation therapy (RT) or concurrent chemoradiation (CRT) therapy. Six studies [ 22 , 27 , 29 , 30 , 33 , 34 ] included surgical patients; however, the prehabilitation program appeared to be implemented preRT/CRT, not pre-surgery. Three studies [ 28 , 37 , 39 ] did not specify if surgical patients were included.…”

Section: Resultsmentioning

confidence: 99%

Prehabilitation in head and neck cancer patients: a literature review

Loewen

Jeffery

Rieger

et al. 2021

J of Otolaryngol - Head & Neck Surg

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Background Dysphagia is one consequence of head and neck cancer that has a significant impact on quality of life for head and neck cancer survivors. While survival rates continue to improve, focus has shifted to maximizing long-term function, with prevention or prehabilitation programs becoming more common. Prehabilitation programs typically include an exercise regime that specifies the exercise type, the number of repetitions to complete per set, the number of sets of each exercise to complete per day, as well as the length of the treatment block. Ideally, exercise programs are designed with principles of neuromuscular plasticity in mind. Methods Twenty-nine original research articles published between 2006 and 2020 were included in this state-of-the-art review and examined for program timing and details. Results Two definitions for prehabilitation were noted: one third of the studies defined prehabilitation as preventative exercises prior to the start of acute cancer treatment; the remaining two thirds defined prehabilitation as treatment concurrent prehabilitation. Exercises prescribed ranged from general stretching and range of motion exercises, to trismus and swallowing specific exercises. The most common swallowing specific exercise was the Mendelsohn’s maneuver, followed by the effortful swallow, Shaker, and Masako maneuver. The most common dose was 10 repetitions of an exercise, three times per day for the duration of radiation therapy. The most common measures were questionnaires, followed by g-tube dependence, mouth opening, and MBS reports. Conclusion This review of the literature has shed light on the variability of prehabilitation timing, exercise type, dose, duration of treatment, and outcomes associated with prehabilitation, making the selection of an optimal prehabilitation program difficult at this time.

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Analysis of dysphagia in advanced-stage head-and-neck cancer patients: impact on quality of life and development of a preventive swallowing treatment

Abstract: 1b and 2b.

Cited by 66 publications

References 35 publications

Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy

Swallowing disorders after treatment for head and neck cancer

Prehabilitation in head and neck cancer patients: a literature review

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