Swallowing function after chemoradiation for advanced stage oropharyngeal cancer

Abstract

Objectives: Advanced stage oropharyngeal cancer may be treated either surgically or nonsurgically. We previously reported functional outcomes following surgical resection with free-tissue transfer. In the present study, we evaluated swallowing function after combined chemoradiation for oropharygeal cancer. Methods: Retrospective review of 30 patients treated at a tertiary academic center for stage III/IV oropharyngeal cancer with sequential or concurrent chemoradiation from 1994–2003. Results: Inclusion criteria were met by 27/30 (90%) patients. Most patients had base of tongue lesions (67%) and stage IV disease (93%). Gastrostomy was performed in 22 (82%) patients either before or during treatment. Three months after chemoradiation, 33% (9/27) were consuming all nutrition orally, 22% (6/27) were NPO, and 45% (12/27) had some oral intake but still required tube feeds. One year after treatment, 53% (10/19) had an exclusively oral diet and only 1 patient (5%) was NPO. In patients without recurrence and follow-up length >1 year, 69% (9/13) were consuming all nutrition orally while 31% still required G-tube support. Conclusions: Long-term dysphagia is common following both surgical and nonsurgical treatment of advanced-stage oropharyngeal SCCA.