Is EAT-10 Useful to Assess Swallowing during the Chemo-Radiotherapy Phase in Patients with Head and Neck Cancer? A Pilot Study

Abstract

Objective/Hypothesis: The 10-item Eating-Assessment Tool (EAT-10) is a dysphagia screening test. In HNC patients, screening and diagnosis of dysphagia are not well-established. To determine the metrological properties of the EAT-10 compared with videofluoroscopy in non-surgical HNC-patients and to assess the relationship between EAT-10 scores and patients’ self-reported symptoms. Study Design: Prospective cohort study. Methods: Forty-six HNC-patients recently diagnosed and referred to chemoradiotherapy (CRT). Main outcome was evidence of dysphagia according to EAT-10 score, self-perception on a Visual Analog Scale (VAS) of impaired swallowing, severity on the Penetration-Aspiration Scale (PAS), and the Functional Oral Intake Scale (FOIS). Patients were assessed at baseline, before-CRT, after-CRT, and at 3-month follow-up. Results: A strong baseline correlation between EAT-10, VAS, and FOIS was observed. All 3 values decreased in weeks 6 to 9 after CRT initiation; a poor correlation of EAT-10 with VAS was observed at 3-month follow-up. A receiver operating characteristic curve determined new cut-off points (sensitivity/specificity) for safe swallowing: baseline 3 (86%, 77%); post-CRT, 15 (62.5%, 80%); and 3-month follow-up, 4 (83%, 75%). Conclusions: New safe-swallow EAT-10-points are suggested for this population during screening and the oncological follow-up. A poor correlation between EAT10-score and patient self-reported symptoms was observed at the end-RT and at 3-month follow-up, highlighting the need for an objective evaluation instrument.

Functional swallowing outcomes related to radiation exposure to dysphagia and aspiration‐related structures in patients with head and neck cancer undergoing definitive and postoperative intensity‐modulated radiotherapy

“…Despite this limitation, no participants in our study who passed the Yale swallow protocol developed aspiration pneumonia. Lastly, Bofill‐Soler et al 50 reported on poor correlation between EAT‐10 scores and swallowing “safety” as rated by the penetration aspiration scale. In this cohort, a comparison was not made between EAT‐10 scores and an instrumental aspiration safety rating.…”

“…It may also be a pertinent topic to explore when establishing a rehabilitation program which engages the patient and promotes adherence to therapy goals. Motivational Interviewing is a technique that empowers the patient to make changes based on what is important to them 50 . While some factors such as taste may not be easy to rehabilitate, ease and comfort swallowing meals could be targeted to facilitate greater enjoyment during meals.…”

Development of a Subjective Symptom Rating Scale for Postoperative Oral Dysfunction in Patients with Oral Cancer: Reliability and Validity of the Postoperative Oral Dysfunction Scale-10

“…Therefore, the scale should be selected according to what one wants to measure in patients with oral cancer. In fact, in addition to the FOIS, the penetration-aspiration Scale is often used to evaluate the performance of the EAT-10, suggesting that the scale is primarily focused on the pharyngeal phase of swallowing or the Stage II transport-to-swallowing phase in the process model of swallowing [24,25]. However, considering that in the actual treatment of advanced oral cancer, neck dissection due to cervical lymph node metastasis, radiation therapy, and chemotherapy are performed as adjuvant therapy, pharyngeal stage disorders often occur even in oral cancer [26][27][28].…”

Prätherapeutische Dysphagie bei Kopf-Hals-Tumor-Patienten

“…Es zeigte sich dabei eine hohe Übereinstimmung der objektivierbaren Schluckbeeinträchtigung mit der sub-Tab. 3 WerteverteilungderPenetrations-Aspirations-Skala(PAS),Functional Oral Intake Scale (FOISumgepolt)undderSkala derversorgungsrelevanten Schluckstörung (VRS) sowie Body-Mass-Index (BMI) in Abhängigkeit von möglichen Einflussfaktoren: vier lineare Regressionen ( jektiven Einschätzung der Patienten, die bereits in einigen früheren Studien für die prätherapeutische Phase demonstriert wurde [24,25].…”

“…[ 11 ] definierte Cut-off-Kriterium ≥ 3 zugrunde. Es zeigte sich dabei eine hohe Übereinstimmung der objektivierbaren Schluckbeeinträchtigung mit der subjektiven Einschätzung der Patienten, die bereits in einigen früheren Studien für die prätherapeutische Phase demonstriert wurde [ 24 , 25 ].…”