Association between severity of dysphagia and survival in patients with head and neck cancer

Abstract

Background This study examined risk factors for dysphagia, a common and serious condition in patients with head and neck cancer, and the association between severity of dysphagia and survival. Methods Chart reviews were performed on patients diagnosed with head and neck cancer between January 2001 and April 2003, who had dysphagia diagnoses or swallowing evaluations. Regression analyses determined factors associated with dysphagia and the association between observed survival and severity of dysphagia. Results Almost 50% of the 407 patients had dysphagia. Risk factors included advanced stage, older age, female sex, and hypopharyngeal tumors. The most severe dysphagia ([L.] nil per os or “nothing by mouth” status), which was associated with lower survival rates, was the strongest independent predictor of survival. Conclusions Swallowing problems should be considered when determining appropriate cancer-directed treatment and posttreatment care. Because of dysphagia’s high incidence rate and association with survival, a speech-language pathologist should be involved to ensure routine diagnostic and therapeutic swallowing interventions.

The quality of life and the occurrence of dysphagia in patients with head and neck cancer following combined oncological treatment

“…The evaluation of severe dysphagia as a late complication of radiotherapy in patients surviving longer than five years was performed by Hutcheson et al The total dose of radiotherapy impacted the occurrence of late dysphagia; it was observed more frequently in patients with a total dose of 70 Gy or higher [26]. Many authors have observed positive effects from proactive swallowing therapy, which were observed not just following the treatment but also 3-6 months after the completion of chemoradiotherapy and 9-12 months after treatment [27][28][29][30][31][32].…”

Effects of palatal augmentation prosthesis in oropharyngeal dysphagia in Chilean patients with tongue cancer: Cases report

“…(1)(2)(3)(4)(5)(6) In addition, there are consequences on the physical and mental condition of patients and it reduces their quality of life (QoL). (7,8) Patients with oral and oropharyngeal cancer are usually treated with surgery, radiotherapy (RT), and chemotherapy (ChT), administered alone or in combination.…”

“…(2)(3)(4)(5)(6)9) The main post-radiotherapy sequelae are mucositis, xerostomia, dysgeusia, hoarseness, fibrosis and osteonecrosis. (1,2) Difficulties with speech, mastication and swallowing are also produced. (1,(3)(4)(5)(6) Chemotherapeutic agents for head and neck cancer (HNC) can impact the ability of patients to swallow thus causing nutritional problems.…”

“…(1,2) Difficulties with speech, mastication and swallowing are also produced. (1,(3)(4)(5)(6) Chemotherapeutic agents for head and neck cancer (HNC) can impact the ability of patients to swallow thus causing nutritional problems. (3) The incidence of post-treatment dysphagia in patients with HNC has previously been reported to be between 50% and 60%.…”

“…(3,8,(10)(11)(12)(13) Furthermore, dysphagia has the potential of life-threatening infection due to aspiration pneumonia. (1) There is ample evidence of the use of palatal augmentation prosthesis (PAP) to enhance dysphagia and dysartria. (4,9,10,12,13) PAP are used to model and lower the palatal vault to offer new contact for the remaining portion of the resected tongue.…”