Effect of Induction Chemotherapy on Swallowing in Head and Neck Cancer Patients

Document Type: Research Articles

Authors

1 SLP Head and Neck Department, Barretos Cancer Hospital, Barretos-SP, Brazil.

2 Center for Researcher Support, Barretos Cancer Hospital, Barretos-SP, Brazil.

3 SLP University of Medicine, São Paulo University, São Paulo-SP, Brazil.

4 Head and Neck Oncology Departament, Barretos Cancer Hospital, Barretos-SP, Brazil

Abstract

Objective: To evaluate the effect of induction chemotherapy on swallowing and swallowing-related quality of life
of patients with oropharyngeal, laryngeal and hypopharyngeal cancer. Study design: Prospective study of 33 patients
with locally advanced tumors who were eligible for treatment with neoadjuvant chemotherapy followed by radiotherapy
and concurrent chemotherapy. A multidimensional assessment of swallowing was performed using the following
tools: (1) Clinical analysis, numerical scale for general pain and painful swallowing, American Speech and Hearing
Association (ASHA) Functional Communication Measures (FCM) swallowing assessment scales, (2) assessment
of Swallowing-Related Quality of Life (The MD Anderson Dysphagia Inventory - MDADI), and (3) swallowing
videofluoroscopy. Results: There was a reduction in general pain scale (p=0.021), and quality of life (emotional,
functional and physical) improved from average limitation (score of 61-80) to minimal limitation (81-100) after
induction chemotherapy. According to the swallowing videofluoroscopy results, 26 (78.7%) of the patients had some
degree of dysphagia pre-treatment, which decreased to 21 (63.6%) after induction. Conclusion: Our results suggest
that induction chemotherapy improves numerous aspects of swallowing and has a positive impact on the quality of
life of pre-chemoradiotherapy patients.

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