Predictors of postradiation swallowing dysfunction in head-and-neck cancer

Abstract

Background: Organ preservation protocols using concurrent chemoradiation therapy is increasingly utilized as a primary treatment for locally advanced head-and-neck cancers. Swallowing dysfunction has been recognized as the most common treatment-related quality of life (QoL) issue affecting 50%–60% of patients. Objective: The aim of the present study was to identify the factors that affect swallowing function after head-and-neck irradiation. Materials and Methods: From 2013 to 2014, 34 patients with squamous cell carcinoma head-and-neck region were prospectively enrolled in this study. The influence of the radiation treatment on swallowing function was evaluated using modified barium swallow test at baseline, 3 months, and 6 months. Chi-squared analysis was used to analyze the factors affecting swallowing function. Results: At 3 months following treatment, 76.5% of patients had swallowing dysfunction which decreased to 61.8% at 6 months. The statistically significant association was found between swallowing dysfunction and primary site in oral cavity and oropharynx (P = 0.04) at 3 months following treatment. Conclusions: While there is an ample literature reporting on several QoL issues for head-and-neck cancer patients, the various factors affecting swallowing dysfunction after the completion of treatment have not been fully described. Understanding the trajectory of swallowing dysfunction is important in identifying patients at high risk of protracted swallowing dysfunction. Providing appropriate early anticipatory intervention may improve patient's QoL. Longer follow-up is required to confirm these predictors of swallowing dysfunction.