Dysphagia, trismus and speech impairment following radiation-based treatment for advanced stage oropharyngeal carcinoma: a one-year prospective evaluation

Karsten, Rebecca T.; Chargi, Najiba; Molen, Lisette van der; Son, R.J.J.H. van; Bree, Remco de; Al‐Mamgani, Abrahim; Boer, Jan Paul de; Hilgers, Frans J. M.; Brekel, Michiel W. M. van den; Smeele, Ludi E.; Stuiver, Martijn M.

doi:10.1007/s00405-021-06870-x

Cited by 8 publications

(6 citation statements)

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“…Only a few studies reported a relationship between OD and body composition or weight loss in oncological populations using different methods, challenging clean comparison with our results. [44][45][46] For the evaluation of the swallowing function, these studies did not perform any biomechanical measurements using VFSS or fiberoptic endoscopic evaluation of swallowing (FEES) nor dysphagia-specific patient-reported outcome measures, and only two studies evaluated pretreatment OD. 44,46 Additionally, the presence of OD was evaluated using investigator-reported dietary intake scales (Food Intake Level Scale and FOIS).…”

Section: Discussionmentioning

confidence: 99%

“…[44][45][46] For the evaluation of the swallowing function, these studies did not perform any biomechanical measurements using VFSS or fiberoptic endoscopic evaluation of swallowing (FEES) nor dysphagia-specific patient-reported outcome measures, and only two studies evaluated pretreatment OD. 44,46 Additionally, the presence of OD was evaluated using investigator-reported dietary intake scales (Food Intake Level Scale and FOIS). Previous research has shown that the FOIS or the level of dietary intake is not a reliable indicator for the severity of OD 47 so that the conclusions of the above-cited studies on the relationship between sarcopenia and OD should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

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Oropharyngeal dysphagia and cachexia: Intertwined in head and neck cancer

et al. 2022

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Background: This study aims to investigate the relationship between cancer cachexia and oropharyngeal dysphagia (OD) in patients with head and neck cancer (HNC) prior to chemoradiotherapy or bioradiotherapy (CRT/BRT).Methods: A prospective cohort study with patients with HNC undergoing CRT/BRT (2018-2021) was conducted. Body composition and skeletal muscle function were evaluated using bioelectrical impedance analysis, handgrip strength, and the short physical performance battery (SPPB). The M. D. Anderson Dysphagia Inventory (MDADI), Eating Assessment Tool (EAT)-10 questionnaire, and patient characteristics were collected. A standardized videofluoroscopic swallowing study was offered to patients.Results: Sixty-six patients were included. Twenty-six patients scored EAT-10 ≥ 3 and seventeen were cachectic. ACE-27 score >1, cachexia, abnormal SPPB-derived repeated chair-stand test, lower MDADI scores, and higher overall stage grouping showed potential predictive value (p ≤ 0.10) for EAT-10 ≥ 3.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Oropharyngeal dysphagia and cachexia: Intertwined in head and neck cancer

et al. 2022

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“…Moreover, low SMM was found to be predictive for length of hospital stay and unplanned admission in HNC patients treated with (chemo)radiotherapy ( 79 ). Low SMM was also associated with long-term morbidity of (chemo)radiation like dysphagia, xerostomia and trismus ( 40 , 80 , 81 ).…”

Section: Sarcopeniamentioning

confidence: 99%

Measurement of Sarcopenia in Head and Neck Cancer Patients and Its Association With Frailty

et al. 2022

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In head and neck cancer (HNC) there is a need for more personalized treatment based on risk assessment for treatment related adverse events (i.e. toxicities and complications), expected survival and quality of life. Sarcopenia, defined as a condition characterized by loss of skeletal muscle mass and function, can predict adverse outcomes in HNC patients. A review of the literature on the measurement of sarcopenia in head and neck cancer patients and its association with frailty was performed. Skeletal muscle mass (SMM) measurement only is often used to determine if sarcopenia is present or not. SMM is most often assessed by measuring skeletal muscle cross-sectional area on CT or MRI at the level of the third lumbar vertebra. As abdominal scans are not always available in HNC patients, measurement of SMM at the third cervical vertebra has been developed and is frequently used. Frailty is often defined as an age-related cumulative decline across multiple physiologic systems, with impaired homeostatic reserve and a reduced capacity of the organism to withstand stress, leading to increased risk of adverse health outcomes. There is no international standard measure of frailty and there are multiple measures of frailty. Both sarcopenia and frailty can predict adverse outcomes and can be used to identify vulnerable patients, select treatment options, adjust treatments, improve patient counselling, improve preoperative nutritional status and anticipate early on complications, length of hospital stay and discharge. Depending on the definitions used for sarcopenia and frailty, there is more or less overlap between both conditions. However, it has yet to be determined if sarcopenia and frailty can be used interchangeably or that they have additional value and should be used in combination to optimize individualized treatment in HNC patients.

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“…Treatment of head and neck cancer (HNC) can affect the anatomy of the upper airway and upper digestive tract, often resulting in impairment of speech and swallowing function [ 10 , 11 ]. Another consequence of this altered anatomy is that it may lead to OSA [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of obstructive sleep apnea after treatment for advanced T-stage head and neck cancer

Karsten,

Rijken,

Toprak

et al. 2024

Eur Arch Otorhinolaryngol

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Purpose Treatment of head and neck cancer (HNC) may lead to obstructive sleep apnea (OSA), but conclusive results on the prevalence of OSA are lacking. The objective of this study is to investigate the prevalence of OSA in a cohort of patients treated for advanced T-stage HNC. Methods A cross-sectional study was conducted in two tertiary cancer care centers including patients at least 1 year after treatment with curative intent with surgery and/or (chemo)radiotherapy ((C)RT) for advanced T-staged (T3-4) cancer of the oral cavity, oropharynx, hypopharynx, or larynx. A polysomnography (PSG) was performed in all participants. OSA was defined as an apnea–hypopnea index (AHI) of 15 events/h or higher or an AHI of 5 events/h and higher with OSA related symptoms, such as sleeping problems, daytime dysfunction and/or cardiac/metabolic comorbidities collected through file review and questionnaires. Results Of the 67 participants, 48 (72%, 95% CI 59–82%) were diagnosed with OSA. Possible risk factors are male gender, higher BMI, greater neck circumference, more nicotine pack years, cardiometabolic comorbidities, use of medication with sleepiness as side effect, present tonsils, lower T-stage (T3 vs. T4 stage), higher AJCC stage and a HPV-negative tumor. Conclusion In this population of advanced T-stage HNC patients, the prevalence of OSA was 72%, which is considerably higher than in the general population (2–50%). Given the high prevalence, screening of this entire subgroup for OSA may be indicated. Future studies to identify high risk factors and develop an OSA screening protocol are needed.

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Dysphagia, trismus and speech impairment following radiation-based treatment for advanced stage oropharyngeal carcinoma: a one-year prospective evaluation

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Cited by 8 publications

References 47 publications

Oropharyngeal dysphagia and cachexia: Intertwined in head and neck cancer

Oropharyngeal dysphagia and cachexia: Intertwined in head and neck cancer

Measurement of Sarcopenia in Head and Neck Cancer Patients and Its Association With Frailty

Prevalence of obstructive sleep apnea after treatment for advanced T-stage head and neck cancer

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