Eat-10 Cut-Off Points to Detect Swallow Dysfunction in Head and Neck Cancer Patients during Radiotherapy: Findings from the “Redyor” Study

Abstract

Dysphagia is a common toxicity of head and neck radiation therapy in patients undergoing chemoradiotherapy (CRT). There are discrepancies between the parameters by the instrumental methods and the perceptions of the patient. The objective of this study is to correlation the 10-item feeding assessment tool (EAT-10) for swallowing disorders, and the Penetration-Aspiration Scale (PAS) score obtained by videofluoroscopy, visual analogic scale (VAS) and functional oral intake scale (FOIS) within 3 months after treatment. We evaluated 46 patients included in “Redyor” study, measured at baseline (diagnosis), before and after initiating CRT, and at 3-month follow-up, were EAT-10, visual analogic scale (VAS) for self-impaired swallow, dysphagia assessed with PAS, functional oral intake scale (FOIS), maximal interincisor opening, and maximum isometric tongue pressure. Who had the EAT-10 test before, the end and 3 months after the treatment, to evaluate the relationship between PAS, VAS, and FOIS. A receiver operating characteristic (ROC) curve determined for the cut-off of the EAT-10. The Spearman correlation coefficients were calculated. A p <0.05 bilateral was considered statistically significant. Functional and self-perception values decreased in weeks 6 to 9 after CRT, coinciding with the worst EAT-10 score. A receiver operating characteristic (ROC) curve determined 3 cut-off points (with their respective sensitivity and specificity): baseline, 3 (86%, 77%); post-CRT, 15 (62.5%, 80%); and 3-month follow-up, 4 (83%, 75%). A strong correlation between VAS, FOIS, and EAT-10 observed at baseline subsequently disappeared. Table 1. New cut-off points for EAT-10 are suggested during the treatment. Our findings confirm the poor relationship between EAT-10 and the instrumental methods and highlight the need to optimize the use of tools to detect and monitor dysphagia in this cohort of patients with high risk of bronchoaspiration EAT-10, Eating Assessment Test; PAS, Penetration-Aspiration scale; VAS visual analogic scale for self-perception swallowing disturbances. Swallowing Rehabilitation in Patients With Head and Neck Cancer Receiving Radiotherapy (ReDyOR) NCT02900911.Abstract 2838; Table 1Spearman correlation coefficients (r) between EAT-10 and PAS, FOIS and VAS in the study periodPASFOISVASBefore chemoradiotherapy (basal)0.314; p=0.0550.340; p=0.0370.451; p=0.005After chemoradiotherapy0.329; p=0.1450.127; p=0.5820.254; p=0.2673-months post-chemoradiotherapy0.275; p=0.3030.008; p=0.9760.005; p=0.987 Open table in a new tab