Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after Radiotherapy
Objective: To evaluate the impact of radiotherapy (RT) on dysphagia and long-term swallowing outcome in patients with stage III and IV head and neck squamous cell carcinomas (HNSCCs). Material and Methods: Between 2005 and 2008, 189 patients with HNSCCs underwent primary or adjuvant RT in a curative...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/10/2688 |
| _version_ | 1797498944271417344 |
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| author | Erdem Yildiz Stefan Grasl Doris-Maria Denk-Linnert Gabriela Altorjai Harald Herrmann Matthaeus C. Grasl Boban M. Erovic Stefan Janik |
| author_facet | Erdem Yildiz Stefan Grasl Doris-Maria Denk-Linnert Gabriela Altorjai Harald Herrmann Matthaeus C. Grasl Boban M. Erovic Stefan Janik |
| author_sort | Erdem Yildiz |
| collection | DOAJ |
| description | Objective: To evaluate the impact of radiotherapy (RT) on dysphagia and long-term swallowing outcome in patients with stage III and IV head and neck squamous cell carcinomas (HNSCCs). Material and Methods: Between 2005 and 2008, 189 patients with HNSCCs underwent primary or adjuvant RT in a curative setting. Long-term swallowing outcome was evaluated in 50 patients. Among them, 26 were further eligible for prospective analysis of long-term swallowing and dysphagia outcome. Medical charts were retrospectively reviewed regarding pre- and post-treatment dysphagia (3 months after last irradiation setting) as well as persisting long-term dysphagia (2019–2021). Results: Pre-treatment dysphagia was observed in 24 (48%) of 50 patients, particularly in oropharyngeal or hypopharyngeal stage III–IV tumors (OR 9.3; <i>p</i> = 0.003). Conversely, 46 patients (92%) complained about post-treatment dysphagic symptoms, which were more commonly seen in patients with positive neck nodes (OR 10.5; <i>p</i> = 0.037). The post-treatment dysphagia rate dropped from 92% to 24% (<i>p</i> < 0.001) during surveillance, which was significantly linked to xerostomia (OR 5.77; <i>p</i> = 0.019), dysgeusia (OR 9.9; <i>p</i> = 0.036) and free flap reconstruction (OR 6.1; <i>p</i> = 0.022). Conclusion: Pretreatment dysphagia is common in advanced stage HNSCCs and almost all patients complain about dysphagia at the end of RT. Importantly, applied RT protocols did not affect long-term dysphagia, which improves significantly in the majority of patients over time. Meeting Information: Preliminary results have been presented at the 65th Annual Meeting of the Austrian Society of Otorhinolaryngology, 22–26 September 2021, Austria. |
| first_indexed | 2024-03-10T03:40:32Z |
| format | Article |
| id | doaj.art-6c526192625f402baa8b992cc24fe0d8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:40:32Z |
| publishDate | 2022-05-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-6c526192625f402baa8b992cc24fe0d82023-11-23T11:33:14ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-011110268810.3390/jcm11102688Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after RadiotherapyErdem Yildiz0Stefan Grasl1Doris-Maria Denk-Linnert2Gabriela Altorjai3Harald Herrmann4Matthaeus C. Grasl5Boban M. Erovic6Stefan Janik7Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Otorhinolaryngology, Division of Phoniatrics and Speech Language Therapy, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Radiation Oncology, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Radiation Oncology, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, AustriaInstitute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, AustriaDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, AustriaObjective: To evaluate the impact of radiotherapy (RT) on dysphagia and long-term swallowing outcome in patients with stage III and IV head and neck squamous cell carcinomas (HNSCCs). Material and Methods: Between 2005 and 2008, 189 patients with HNSCCs underwent primary or adjuvant RT in a curative setting. Long-term swallowing outcome was evaluated in 50 patients. Among them, 26 were further eligible for prospective analysis of long-term swallowing and dysphagia outcome. Medical charts were retrospectively reviewed regarding pre- and post-treatment dysphagia (3 months after last irradiation setting) as well as persisting long-term dysphagia (2019–2021). Results: Pre-treatment dysphagia was observed in 24 (48%) of 50 patients, particularly in oropharyngeal or hypopharyngeal stage III–IV tumors (OR 9.3; <i>p</i> = 0.003). Conversely, 46 patients (92%) complained about post-treatment dysphagic symptoms, which were more commonly seen in patients with positive neck nodes (OR 10.5; <i>p</i> = 0.037). The post-treatment dysphagia rate dropped from 92% to 24% (<i>p</i> < 0.001) during surveillance, which was significantly linked to xerostomia (OR 5.77; <i>p</i> = 0.019), dysgeusia (OR 9.9; <i>p</i> = 0.036) and free flap reconstruction (OR 6.1; <i>p</i> = 0.022). Conclusion: Pretreatment dysphagia is common in advanced stage HNSCCs and almost all patients complain about dysphagia at the end of RT. Importantly, applied RT protocols did not affect long-term dysphagia, which improves significantly in the majority of patients over time. Meeting Information: Preliminary results have been presented at the 65th Annual Meeting of the Austrian Society of Otorhinolaryngology, 22–26 September 2021, Austria.https://www.mdpi.com/2077-0383/11/10/2688squamous cell carcinomahead and neck cancerswallowing disorderdysphagiaadjuvant therapyradiotherapy |
| spellingShingle | Erdem Yildiz Stefan Grasl Doris-Maria Denk-Linnert Gabriela Altorjai Harald Herrmann Matthaeus C. Grasl Boban M. Erovic Stefan Janik Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after Radiotherapy Journal of Clinical Medicine squamous cell carcinoma head and neck cancer swallowing disorder dysphagia adjuvant therapy radiotherapy |
| title | Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after Radiotherapy |
| title_full | Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after Radiotherapy |
| title_fullStr | Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after Radiotherapy |
| title_full_unstemmed | Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after Radiotherapy |
| title_short | Long-Term Swallowing Outcome and Dysphagia in Advanced Staged Head and Neck Squamous Cell Carcinomas after Radiotherapy |
| title_sort | long term swallowing outcome and dysphagia in advanced staged head and neck squamous cell carcinomas after radiotherapy |
| topic | squamous cell carcinoma head and neck cancer swallowing disorder dysphagia adjuvant therapy radiotherapy |
| url | https://www.mdpi.com/2077-0383/11/10/2688 |
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