Swallow Function in Patients Before and After Intra‐Arterial Chemoradiation

Graner, Darlene E.; Foote, Robert L.; Kasperbauer, Jan L.; Stoeckel, Ruth; Okuno, Scott H.; Olsen, Kerry D.; Sabri, Alain; Maragos, Nicolas E.; Stephen, S.; Sargent, Daniel J.; Strome, Scott E.

doi:10.1097/00005537-200303000-00033

Cited by 79 publications

(114 citation statements)

References 16 publications

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“…Finally, 15 papers answered all four speciWc criteria with (yes) [13,22,23,27,34,40,42,45,51,52,59,60,65,69,81] (Fig. 1).…”

Section: Exclusion Criteriamentioning

confidence: 99%

“…Statistical analyses and results were available and presented in clear tables and Wgures in most articles. Three of the Wve studies mentioned inter-and intra-observer reliability of videoXuoroscopic modiWed barium swallow examination (VMBS) [13,40,42,52,60]. For the other ten studies (67%) this aspect was not applicable.…”

Section: General Wndingsmentioning

confidence: 99%

“…For the other ten studies (67%) this aspect was not applicable. Nine of 15 studies (60%) reported reasons and extent of missing data, such as patient drop out and death [4,22,23,27,34,42,45,51,60,65]. Replication of two-thirds of these 15 studies would not be possible as a result of missing information about patients, and assessment methods.…”

Section: General Wndingsmentioning

confidence: 99%

“…Eight of the reviewed articles reported on swallowing function [13,40,42,45,52,60,65,81]. Two studies used a patient self-report questionnaire or a standardized qualityof-life questionnaire [40,45].…”

Section: Crt and Swallowingmentioning

confidence: 99%

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Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Molen

Rossum

Burkhead

et al. 2008

Eur Arch Otorhinolaryngol

110

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Organ preservation with radiotherapy and concomitant chemotherapy has become an accepted treatment modality in advanced head and neck cancer. Unfortunately, organ preservation is not synonymous with function preservation. The aim of this review was to systematically assess the eVects of the disease and chemoradiotherapy (CRT) on functions such as swallowing, mouth opening, nutrition, pain and quality of life in patients with head and neck cancer. Another aim was to search for (evidence-based) techniques or strategies known to alleviate or rehabilitate the loss of function(s) associated with CRT. Two databases were searched (time period, January 1997 to August 2007) for the terms head and neck cancer, chemotherapy or cisplatin and radiotherapy, and the functional outcomes swallowing, trismus, nutrition, pain and quality of life or a variation of those words. In total, 15 relevant articles were identiWed that met the inclusion criteria. The majority of the studies that met the criteria focused on the outcomes swallowing, quality of life, and nutrition. Two studies reported on the outcome pain, but no paper reported on the outcome trismus. Only two papers mentioned rehabilitation options, but speciWc information was lacking. Further long-term prospective research is essential, not only to determine the function impairment caused by the tumor and CRT, but also to assess the eVects of known and newly developed rehabilitation measures. Therefore, in September 2006, the Netherlands Cancer Institute started a randomised clinical trial (RCT): Prevention of trismus, swallowing and speech problems in patients treated with chemoradiotherapy for advanced head and neck cancer. This systematic review was carried out to collect the baseline information for the future outcomes of this RCT.

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“…Finally, 15 papers answered all four speciWc criteria with (yes) [13,22,23,27,34,40,42,45,51,52,59,60,65,69,81] (Fig. 1).…”

Section: Exclusion Criteriamentioning

confidence: 99%

Section: General Wndingsmentioning

confidence: 99%

Section: General Wndingsmentioning

confidence: 99%

Section: Crt and Swallowingmentioning

confidence: 99%

See 2 more Smart Citations

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Molen

Rossum

Burkhead

et al. 2008

Eur Arch Otorhinolaryngol

110

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“…15,18,19 Delayed triggering swallowing reflex, impairment in velopharyngeal closure, decreased tongue base retraxion, pharyngeal contraction, hyolaryngeal elevation, airway closure, upper esophageal sphincter (UOS) opening and increased residue in tongue base, vallecula, pharynx and pyriform sinus were determined as phryngeal disorders after RT. 3,14,15,[20][21][22][23] In a study, decreased tongue base retraxion and hyolaryngeal elevation 1 month after CRT, delayed triggering swallowing reflex, impairment in airway closure 3 months after CRT, decreased UOS opening 6 and 12 months after CRT were found. They stated that these results related to decreased oral intake.…”

Section: Discussionmentioning

confidence: 99%

Head and Neck Cancer: Changes in Artrokinematic Parameters of Neck and Swallowing Function after Radiotherapy

Selen¹

2013

UHOD

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The study aimed to show the changes on artrokinematic parameters of the neck and swallowing function after radiotherapy (RT) in head and neck cancer (HNC) patients. The fourty patients with HNC have been evaluated before, 1 and 3 months after RT. The posture, normal joint movement, muscle strength and endurance of the neck were evaluated as artrokinematic parameters. The clinical and radiological swallowing function evaluations were also done. Mean age of patients were 53,22±10,92 years. Head anterior tilt, kyphosis and shoulder protraction were more in the 3rd month after RT in posture analysis (p< 0.001). The neck flexion, lateral flexion and rotation limitations have increased (p< 0.001), neck muscle strength and endurance have gradually decreased (p< 0,001) after RT. At the same time, swallowing phases have been adversely affected after RT with all these side effects (p< 0.001) and the severity of aspiration in all consistencies has increased gradually (p< 0.05). As a result, RT starts to show its negative effects from the early period of cancer treatment. Unlike other studies, we concluded that RT affects head and neck structures negatively and these describes how RT affects swallowing function. So it is highly important to include head and neck structure mobility, strength and endurance assessments and exercises in swallowing rehabilitation.Keywords: Head and neck cancer, Radiotherapy, Swallowing, Neck structures, Dysphagia ÖZET Bafl Boyun Kanseri: Radyoterapi Sonras› Boyun Artrokinematik Parametreleri ve Yutma Fonksiyonundaki De¤iflikliklerÇal›flman›n amac›; bafl boyun kanserli (BBK) hastalarda radyoterapi (RT) sonras› boyun artrokinematik parametreleri ve yutma fonksiyonundaki de¤ifliklikleri göstermektir. BBK'l› 40 hasta RT öncesi, sonras› 1 ve 3. aylarda de¤erlendirildi. Artrokinematik parametreler olarak boyun postür, normal eklem hareketi, kas kuvvet ve endurans› de¤erlendirildi. Klinik ve radyolojik yutma fonksiyon de¤er-lendirmeleri de yap›ld›. Hastalar›n yafl ortalamas› 53,22±10,92 y›ld›. Postür analizinde bafl anterior tilti, kifoz ve omuz protraksiyonu RT sonras› 3. ayda daha fazla idi (p< 0.001). RT sonras› boyun fleksiyon, lateral fleksiyon ve rotasyon limitasyonlar› artt› (p< 0.001), boyun kas kuvvet ve endurans› giderek azald› (p< 0.001). Ayn› zamanda RT sonras› tüm bu yan etkilerle birlikte yutma fazlar› kötü yönde etkilendi (p< 0.001) ve tüm k›vamlarda aspirasyon fliddeti giderek artt› (p< 0.05). Sonuç olarak RT erken dönemden itibaren olumsuz etkilerini göstermeye bafllamaktad›r. Di¤er çal›flmalardan farkl› olarak RT'nin bafl ve boyun yap›lar›n› olumsuz yönde etkiledi¤i ortaya konuldu ve bu da RT'nin yutma fonksiyonunu nas›l etkiledi¤i aç›klamaktad›r. Bu yüzden yutma rehabilitasyonuna bafl boyun yap› hareketlilik, kuvvet ve endurans de¤erlendirme ve egzersizlerini dahil etmek çok önemlidir.

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Characteristics Associated With Swallowing Changes After Concurrent Chemotherapy and Radiotherapy in Patients With Head and Neck Cancer

Salama¹,

Stenson²,

List³

et al. 2008

Arch Otolaryngol Head Neck Surg

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To define factors that acutely influenced swallowing function prior to and during concurrent chemotherapy and radiotherapy. Design: A summary score from 1 to 7 (the swallowing performance status scale [SPS]) of oral and pharyngeal impairment, aspiration, and diet, was assigned to each patient study by a single senior speech and swallow pathologist, with higher scores indicating worse swallowing. Generalized linear regression models were formulated to asses the effects of patient factors (performance status, smoking intensity, amount of alcohol ingestion, and age), tumor factors (primary site, T stage, and N stage), and treatment-related factors (radiation dose, use of intensity-modulated radiation therapy, response to induction chemotherapy, postchemoradiotherapy neck dissection, and preprotocol surgery) on the differences between SPS score before and after treatment. Setting: University hospital tertiary care referral center. Patients: The study included 95 patients treated under a multiple institution, phase 2 protocol who underwent a videofluorographic oropharyngeal motility (OPM) study to assess swallowing function prior to and within 1 to 2 months after the completion of concurrent chemotherapy and radiotherapy. Main Outcome Measures: Factors associated with swallowing changes after chemoradiotherapy. Results: The mean pretreatment and posttreatment OPM scores were 3.09 and 3.77, respectively. Patients with T3 or T4 tumors (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.15-0.95; P =.04) and a performance status of 1 or 2 (OR, 0.37; 95% CI, 0.15-0.91; P =.03) were less likely to have worsening of swallowing after chemoradiotherapy. There was a trend for worse swallowing with increasing age (OR, 1.04; 95% CI, 0.99-1.09; P=.08). Only T stage (T3 or T4) was associated with improved swallowing after treatment (OR, 8.96; 95% CI, 1.9-41.5; PϽ .001). Conclusion: In patients undergoing concurrent chemotherapy and radiotherapy, improved swallowing function over baseline is associated with advanced T stage.

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Swallow Function in Patients Before and After Intra‐Arterial Chemoradiation

Cited by 79 publications

References 16 publications

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Head and Neck Cancer: Changes in Artrokinematic Parameters of Neck and Swallowing Function after Radiotherapy

Characteristics Associated With Swallowing Changes After Concurrent Chemotherapy and Radiotherapy in Patients With Head and Neck Cancer

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