Abstract
AbstractRadiation therapy and radiochemotherapy protocols can cause swallowing difficulties.Aim: To evaluate swallowing in patients undergoing radiation therapy and radiochemotherapy protocol only for the treatment of laryngeal tumors.Methods: A prospective study of 20 patients, with a mean age of 62 years, at the end of oncological therapy. Six patients (30%) underwent radiation therapy, and 14 patients (70%) underwent combined therapy. The mean time between treatment and an evaluation of swallowing was 8.5 months. Videofluoroscopy was done to assess the preparatory, oral and pharyngeal phases of swallowing.Results: All patients had only an oral diet. Normal swallowing was present in only 25% of patients. The swallowing videofluoroscopic examination identified the following changes: bolus formation (85%), bolus ejection (60%), oral cavity stasis (55%), changes in the onset of the pharyngeal phase (100%), decreased laryngeal elevation (65%), and hypopharyngeal stasis (80%). Laryngeal penetration was observed in 25% of the cases; 40% presented tracheal aspiration. The grade of penetration/ aspiration was mild in 60% of cases. Aspiration was silent in 35% of patients. Although 75% of patients had dysphagia, only 25% complained of swallowing difficulties.Conclusion: Patients with laryngeal cancer that underwent radiation therapy/combined treatment can present changes in all swallowing phases, or may be asymptomatic.
Highlights
Treatment for initial or advanced head and neck tumors may include radiotherapy alone or associated with surgery and chemotherapy.[1]
Late functional results were analyzed based on videofluoroscopy swallow studies of 31 subjects after the end of combined radiotherapy and chemotherapy
Swallowing was considered functional in 35.5% of patients; mild to moderate dysphagia was found in 54.8% of the sample, and severe dysphagia was encountered in 9.6% of patients.[7]
Summary
Treatment for initial or advanced head and neck tumors may include radiotherapy alone or associated with surgery and chemotherapy.[1]. A current debate is the impact of this type of therapy on laryngeal function and quality of life, since treatment may cause malnutrition, dehydration, weight loss, pain, dysphonia, dysphagia and ototoxicity.[4] Radiotherapy alone may cause several dysfunctions in different degrees, such as: xerostomy, odynophagia, weight loss, and a need for alternative feeding routes.[5]. Disordered swallowing affects feeding efficiency and safety; regardless of severity, the quality of life and several lifestyle aspects may be compromised.[6]. Late functional results were analyzed based on videofluoroscopy swallow studies of 31 subjects after the end of combined radiotherapy and chemotherapy. None of these patients had been treated with swallowing therapy at the time of evaluation. Swallowing was considered functional in 35.5% of patients; mild to moderate dysphagia was found in 54.8% of the sample, and severe dysphagia was encountered in 9.6% of patients.[7]
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