Association Between Objective Ratings of Swallowing and Dysphagia-Specific Quality of Life in Patients Receiving (Chemo)radiotherapy for Oropharyngeal Cancer

Wishart, Laurelie R; Harris, Grace; Cassim, Nabeela; Alimin, Stephanie; Liao, Ting; Brown, Bena; Ward, Elizabeth C.; Nund, Rebecca L.

doi:10.1007/s00455-021-10364-7

Cited by 9 publications

(8 citation statements)

References 35 publications

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“…Previous research on the correlation between objective findings and QoL is highly controversial. In head and neck cancer patients, this limited correlation was observed when comparing multiple questionnaires alongside different accurate diagnostic methods in heterogeneous patient cohorts [18][19][20][21][22][23][24][25][26][27][28][29]49,50]. Standardized objective diagnostics, such as FEES [17,[20][21][22][23][24] or VFSS [18,19,22,[25][26][27][28][29], were commonly utilized, primarily focusing on measuring penetration and aspiration during swallowing.…”

Section: Discussionmentioning

confidence: 99%

“…However, the validity of PROs in evaluating swallowing function in HNSCC is controversial: Some studies indicate significant correlations between subjective swallowing difficulties and objective parameters such as oropharyngeal swallowing efficiency, bolus transport time, residue, and aspiration [14][15][16][17]. Nevertheless, most research suggests a tenuous relationship between these measures, particularly concerning penetration and aspiration [18][19][20][21][22][23][24][25][26][27][28][29]. The present study aimed to determine if central European patients with tumors primarily attributable to smoking and/or alcohol can accurately assess their physiologic swallowing functioning using the most widely employed questionnaire, MDADI [12,[30][31][32].…”

Section: Introductionmentioning

confidence: 99%

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Head and Neck Cancer: A Study on the Complex Relationship between QoL and Swallowing Function

Strüder,

Ebert,

Kalle

et al. 2023

Current Oncology

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Head and neck squamous cell carcinoma (HNSCC) is linked to significant morbidity, adversely affecting survival and functional capacity. Post-treatment challenges such as pain, dysphonia, and dysphagia are common, prompting increased attention in survivorship research. Quality of Life (QoL) questionnaires, especially the MD Anderson Dysphagia Inventory (MDADI), are prevalent outcome measures in clinical studies but often lack parallel objective swallowing function evaluations, leading to potential outcome discrepancies. This study aimed to illuminate the relationship between subjective QoL (EQ-5D-5L and MDADI) measures and objective swallowing function (evaluated via Fiberoptic Endoscopic Evaluation of Swallowing, FEES) in patients with HNSCC. The analysis revealed a notable discordance between objective measures of swallowing function, such as the Penetration–Aspiration Scale (PAS) and residue ratings in the vallecula or piriform sinus, and patients’ subjective QoL assessments (p = 0.21). Despite the lack of correlation, swallowing-related QoL, as measured by the MDADI, was more indicative of disease severity than generic QoL assessments. Generic QoL scores did not demonstrate substantial variation between patients. In contrast, MDADI scores significantly declined with advancing tumor stage, multimodal therapy, and reliance on feeding tubes. However, the clinical significance of this finding was tempered by the less than 10-point difference in MDADI scores. The findings of this study underline the limitations of QoL measures as standalone assessments in patients with HNSCC, given their reliance on patient-perceived impairment. While subjective QoL is a crucial aspect of evaluating therapeutic success and patient-centric outcomes, it may fail to capture critical clinical details such as silent aspirations. Consequently, QoL assessments should be augmented by objective evaluations of swallowing function in clinical research and practice to ensure a holistic understanding of patient well-being and treatment impact.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Head and Neck Cancer: A Study on the Complex Relationship between QoL and Swallowing Function

Strüder,

Ebert,

Kalle

et al. 2023

Current Oncology

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“…Recent studies have found correlations between objective measures of swallowing and PROMs. Studies that have looked at correlations between WST and PROMs have found some correlations with both the UWQOL swallow item [39] MDADI and PSS-HN [40] and between the Modified Barium Swallow Impairment Profile (MBSImp)and the MDADI [41]. This suggests that assessment of the perception of the patients of their swallow function may also have the potential to highlight patients who may require intervention.…”

Section: Strengths and Limitations Of Patient-reported Outcome Measuresmentioning

confidence: 99%

Addressing patients’ concerns in speech and language therapy consultations following the diagnosis and treatment of head and neck cancer

Zuydam

Rogers

Roe

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewHead and neck cancer (HNC) and its treatment impacts profoundly on patients’ functional abilities, emotional well being and social interactions. Communication and swallowing are fundamental to everyday life, and the Speech and Language Therapist (SLT) has a critical role for both patients and their carers. In clinical practice, patient-reported outcome measures (PROMs) are a key part of the armamentarium of the SLT. The purpose of the review is to summarize how these measures can be beneficial in the context of time pressured SLT outpatient consultations.Recent findingsUnmet needs in HNC are common and impact negatively on quality of life. There is an ever-increasing number of articles in this area, and it can be a challenge to identify, distil and summarize those specific to SLT.SummaryIn this review, we discuss the scope of holistic evaluation, strengths and limitations of PROMs, the Patient Concerns Inventory-Head and Neck, barriers to the use of outcome measures, the carers perspective and surveillance. SLT are uniquely placed members of the multidisciplinary team and provide expert advice and intervention. The inclusion of PROMs in routine consultations provides a model of follow up, which helps address patients and carers complex and unmet needs, ultimately promoting better outcomes.

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“…Postradiation dysphagia is associated with significant morbidity for people with HNC (e.g. malnutrition, aspiration pneumonia), and can have profound negative impacts on psychosocial function [8,9].…”

Section: Imaging In Dysphagiamentioning

confidence: 99%

Advances in and applications of imaging and radiomics in head and neck cancer survivorship

Wishart

Ward

Galloway

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of Review Radiological imaging is an essential component of head/neck cancer (HNC) care. Advances in imaging modalities (including CT, PET, MRI and ultrasound) and analysis have enhanced our understanding of tumour characteristics and prognosis. However, the application of these methods to evaluate treatment-related toxicities and functional burden is still emerging. This review showcases recent literature applying advanced imaging and radiomics to the assessment and management of sequelae following chemoradiotherapy for HNC. Recent findings Whilst primarily early-stage/exploratory studies, recent investigations have showcased the feasibility of using radiological imaging, particularly advanced/functional MRI (including diffusion-weighted and dynamic contrast-enhanced MRI), to quantify treatment-induced tissue change in the head/neck musculature, and the clinical manifestation of lymphoedema/fibrosis and dysphagia. Advanced feature analysis and radiomic studies have also begun to give specific focus to the prediction of functional endpoints, including dysphagia, trismus and fibrosis. Summary There is demonstrated potential in the use of novel imaging techniques, to help better understand pathophysiology, and improve assessment and treatment of functional deficits following HNC treatment. As larger studies emerge, technologies continue to progress, and pathways to clinical translation are honed, the application of these methods offers an exciting opportunity to transform clinical practices and improve outcomes for HNC survivors.

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Association Between Objective Ratings of Swallowing and Dysphagia-Specific Quality of Life in Patients Receiving (Chemo)radiotherapy for Oropharyngeal Cancer

Cited by 9 publications

References 35 publications

Head and Neck Cancer: A Study on the Complex Relationship between QoL and Swallowing Function

Head and Neck Cancer: A Study on the Complex Relationship between QoL and Swallowing Function

Addressing patients’ concerns in speech and language therapy consultations following the diagnosis and treatment of head and neck cancer

Advances in and applications of imaging and radiomics in head and neck cancer survivorship

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