Patient-Reported Voice and Speech Outcomes After Whole-Neck Intensity Modulated Radiation Therapy and Chemotherapy for Oropharyngeal Cancer: Prospective Longitudinal Study

Vainshtein, Jeffrey M.; Griffith, Kent A.; Feng, Felix Y.; Vineberg, K.A.; Chepeha, Douglas B.; Eisbruch, Avraham

doi:10.1016/j.ijrobp.2014.03.013

Cited by 42 publications

(49 citation statements)

References 30 publications

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“…To date, there are little studies that evaluated VHI scores after CCRT treatment for HNC, especially at long term. In recent studies that evaluated voice quality, results showed decreases in voice quality following CCRT [6,40], with an impact on QoL and emotional distress [42]. Though almost the whole VHI range (0-91) was covered in our patient population (with various tumor sites included) at 6 years post-treatment, the median total VHI score was only three.…”

Section: Voice Qualitymentioning

confidence: 72%

“…Previously, only few studies with adequate pre-treatment data prospectively investigated effects of CCRT on voice quality, and the available studies often used different diagnostic tests [9-11, 34, 36]. Longest follow-up was a year in all, except for the study of Vainshtein et al [6] that evaluated voice changes up to 2 years following CCRT. However, only patient-reported voice quality was assessed in that study, while especially acoustic voice parameters at long-term follow-up would be informative, since changes in voice quality (i.e., more nasality) after 6 years of follow-up are demonstrable in our study.…”

Section: Voice Qualitymentioning

confidence: 99%

“…Furthermore, dysphagia can adversely affect compliance to treatment and post-treatment recovery (e.g., because of aspiration problems), and can deteriorate patient's social contacts and quality of life (QoL) [3]. Since radiation fields frequently encompass the larynx, also substantial effects on voice quality have been noted, which are correlated to the RT dose to the larynx [4][5][6]. Combination with chemotherapy aggravates these negative effects on patients' speech, daily life activities, and again QoL [7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, only few studies with adequate pretreatment data collection prospectively investigated changes in patient-and observer-rated voice quality [6,[9][10][11][34][35][36]. Longest follow-up was a year in all.…”

Section: Introductionmentioning

confidence: 99%

“…As a result, abnormal acoustic and aerodynamic measures (harmonicsto-noise ratio, fundamental frequency, measures of jitter, shimmer, and spectral tilt) have been demonstrated in irradiated HNC patients. Also subjective voice problems, often assessed with the Voice Handicap Index (VHI), are reported in the available but limited literature on this topic [6,[38][39][40][41][42].…”

Section: Introductionmentioning

confidence: 99%

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Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises

Kraaijenga

Molen

Jacobi

et al. 2014

Eur Arch Otorhinolaryngol

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Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs.

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Section: Voice Qualitymentioning

confidence: 72%

Section: Voice Qualitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises

Kraaijenga

Molen

Jacobi

et al. 2014

Eur Arch Otorhinolaryngol

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Association of Risk Factors With Patient-Reported Voice and Speech Symptoms Among Long-term Survivors of Oropharyngeal Cancer

Aggarwal

Hutcheson

Garden

et al. 2021

JAMA Otolaryngol Head Neck Surg

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Key Points Question What factors are associated with moderate to severe voice and speech symptoms among long-term survivors of oropharyngeal cancer (OPC)? Findings In this retrospective cohort study with cross-sectional survivorship survey administration, of 881 survivors of OPC who were included in analysis, 113 (12.8%) reported moderate to severe voice and speech symptoms. Increasing survival time and total radiation dose, Black race, Hispanic ethnicity, current cigarette smoking at the time of the survey, multimodality treatment with induction and concurrent chemotherapy, and late and baseline lower cranial neuropathy were identified as risk factors for moderate to severe voice and speech symptoms, and an intensity-modulated split-field radiotherapy regimen was associated with better voice and speech symptoms. Meaning These findings may have clinical implications for OPC treatment and survivorship, and the preservation of function and quality of life should be considered without compromising oncological outcomes.

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Maintaining physical activity during head and neck cancer treatment: Results of a pilot controlled trial

et al. 2015

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Background Concurrent chemoradiotherapy (concurrent CRT) to treat head and neck cancer is associated with significant reductions of weight, mobility, and quality of life (QOL). An intervention focusing on functional exercise may attenuate these losses. Methods We allocated patients to a 14-week functional resistance and walking program designed to maintain physical activity during cancer treatment (MPACT group; n = 11), or to usual care (control group; n = 9). Outcomes were assessed at baseline, and 7 and 14 weeks. Results Compared to controls, the MPACT participants had attenuated decline or improvement in several strength, mobility, physical activity, diet, and QOL endpoints. These trends were statistically significant (p < .05) in knee strength, mental health, head and neck QOL, and barriers to exercise. Conclusion In this pilot study of patients with head and neck cancer undergoing concurrent CRT, MPACT training was feasible and maintained or improved function and QOL, thereby providing the basis for larger future interventions with longer follow-up.

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Patient-Reported Voice and Speech Outcomes After Whole-Neck Intensity Modulated Radiation Therapy and Chemotherapy for Oropharyngeal Cancer: Prospective Longitudinal Study

Cited by 42 publications

References 30 publications

Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises

Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises

Association of Risk Factors With Patient-Reported Voice and Speech Symptoms Among Long-term Survivors of Oropharyngeal Cancer

Maintaining physical activity during head and neck cancer treatment: Results of a pilot controlled trial

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