Functional Outcomes of Chemoradiotherapy in Patients with Head and Neck Cancer

Abstract

Objective: Concurrent chemoradiotherapy has become the treatment of choice for oropharyngeal and hypopharyngolaryngeal cancers in many centers. Although it has increased the rates of organ preservation, there has also been an increase in treatment-related complications. We aimed to evaluate the functional outcomes of chemoRT in head and neck cancer. Method: A retrospective study of patients treated with chemoRT at the University of Arkansas for Medical Sciences was performed. Demographic data and treatment outcomes were extracted, specifically feeding tube and tracheotomy dependence, number of esophageal dilatations, and the rate of hypothyroidism. Results: Of the 243 patients treated with concurrent chemoRT, 152 patients received a feeding tube. The average duration of PEG use was 12 months (range, 1-96 months). More than 70% of the patients who had a PEG more than 6 months had a T3 or T4 tumor. Thirty-seven patients underwent esophageal dilatations, with an average of 1.8 times (range, 1-7). The average duration for a tracheotomy was 11 months and 77% of these patients were treated for hypopharyngolaryngeal cancer. Of note, 42 patients were found to be hypothyroid, with no significant difference between the hypopharyngolaryngeal and oropharyngeal cancers. Conclusion: Concurrent chemoradiotherapy leads to significant complications that reduce the quality of life of a patient. In this series 71% of the patients were feeding tube dependent despite completion of therapy more than 6 months ago. Prospective studies are needed to determine risk factors leading to increased dysphagia and tracheotomy dependence.