Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Dysphagia in Patients with Nasopharyngeal Cancer After Radiation Therapy: A Videofluoroscopic Swallowing Study

  • 775 Accesses

  • 65 Citations


This study evaluated swallowing status and the factors influencing swallowing in patients with nasopharyngeal carcinoma (NPC) after radiation therapy. During the period from July 1995 to June 1999, this cross-sectional study used videofluoroscopic swallowing study (VFSS) to evaluate 184 NPC patients who had completed radiation therapy [113 cases had completed radiation therapy ≤12 months prior to evaluation (acute group) and 71 cases had completed radiation therapy >12 months prior to evaluation (chronic group)]. The numbers of patients with tumors in each of the four stages were as follows: 24 in stage I, 45 in stage II, 41 in stage III, and 74 in stage IV. Swallowing abnormalities of the acute and chronic groups were correlated with multiple variables, including gender, age, the stage of the tumor, use of either neoadjuvant chemotherapy or radiosensitizer, and radiation modality. The analytical results indicated that the chronic group had a significantly higher proportion of swallowing abnormalities. Radiation modality, chemotherapy, and tumor staging were not significantly associated with swallowing dysfunction. Trend analysis revealed a progressive deterioration of most parameters of swallowing function in this group of patients. These findings indicate that swallowing function continues to deteriorate over time, even many years after radiation therapy in patients with NPC. Our results indicate that the time elapsed since radiation therapy correlates with the severity of dysphagia in NPC patients.

This is a preview of subscription content, log in to check access.


  1. 1

    Statistical results of leading causes of deaths in the Taiwan area, Department of Health, the Executive Yuan, Republic of China, 1991–1997 (http://www.doh.gov.tw/ )

  2. 2

    SC Huang LT Lui TC Lynn (1985) ArticleTitleNasopharyngeal cancer: study III. A review of 1206 patients treated with combined modalities. Int J Radiat Oncol Biol Phys 11 1789–1793 Occurrence Handle1:STN:280:BimD3cjnsVA%3D Occurrence Handle2412999

  3. 3

    WZ Chen DL Zhou KS Luo (1989) ArticleTitleLong-term observation after radiotherapy for nasopharyngeal carcinoma (NPC). Int J Radiat Oncol Biol Phys 16 311–314 Occurrence Handle1:STN:280:BiaC2MritFY%3D Occurrence Handle2921131

  4. 4

    IW Dimery LJ Peters PH Goepfert WH Morrison RM Byers C Guillory K McCarthy RS Weber WK Hong (1993) ArticleTitleEffectiveness of combined induction chemotherapy and radiotherapy in advanced nasopharyngeal carcinoma. J Clin Oncol 11 1919–1928 Occurrence Handle1:STN:280:ByuD3MritFU%3D Occurrence Handle8410119

  5. 5

    JD Chencharick KL Mossman (1983) ArticleTitleNutritional consequences of the radiotherapy of head and neck cancer. Cancer 51 811–815 Occurrence Handle1:STN:280:BiyC3c3nvFU%3D Occurrence Handle6821847

  6. 6

    A Kuten H Ben-Aryeh I Berdicevsky L Ore R Szargel D Gutman E Robinson (1986) ArticleTitleOral side effects of head and neck irradiation: correlation between clinical manifestations and laboratory data. Int J Radiat Oncol Biol Phys 12 401–405 Occurrence Handle1:STN:280:BimC28jmvVU%3D Occurrence Handle3957738

  7. 7

    CH Wu TY Hsiao JY Ko MM Hsu (2000) ArticleTitleDysphagia after radiotherapy: endoscopic examination of swallowing in patients with nasopharyngeal carcinoma. Ann Otol Rhinol Laryngol 109 320–325 Occurrence Handle1:STN:280:DC%2BD3c7pvFGkuw%3D%3D Occurrence Handle10737318

  8. 8

    JA Logemann (1983) Evaluation of swallowing disorder. JA Logemann (Eds) Evaluation and treatment of swallowing disorders San Diego, CA College-Hill Press 89–100

  9. 9

    CH Wu TY Hsiao JC Chen YC Chang SY Lee (1997) ArticleTitleEvaluation of swallowing safety with fiberoptic endoscope: comparison with videofluoroscopic technique. Laryngoscopy 107 396–401 Occurrence Handle1:STN:280:ByiB3sfltlE%3D

  10. 10

    RL Hong LL Ting JY Ko MM Hsu TS Sheen PJ Lou CC Wang NN Chung LT Lui (2001) ArticleTitleInduction chemotherapy with mytomycin, epirubicin, cisplatin, fluorouracil, and leucovorin followed by radiotherapy in the treatment of locaregionally advanced nasopharyngeal cancinoma. J Clin Oncol 19 4305–4313 Occurrence Handle1:CAS:528:DC%2BD3MXptlGjtLY%3D Occurrence Handle11731513

  11. 11

    JB Palmer KV Kuhlemeier DC Tippett C Lynch (1993) ArticleTitleA protocol for the videofluorographic swallowing study. Dysphagia 8 209–214 Occurrence Handle1:STN:280:ByyA28rjtVc%3D Occurrence Handle8359040

  12. 12

    AL Perlman BM Booth JP Grayhack (1994) ArticleTitleVideofluoroscopic predictors of aspiration in patients with oropharyngeal dysphagia. Dysphagia 9 90–95 Occurrence Handle1:STN:280:ByuB2szlsFI%3D Occurrence Handle8005013

  13. 13

    JS Cooper KF Fu J Marks S Silverman (1995) ArticleTitleLate effects of radiation therapy in the head and neck region. Int J Radiat Oncol Biol Phys 31 1141–1164 Occurrence Handle10.1016/0360-3016(94)00421-G Occurrence Handle1:STN:280:ByqB38bks10%3D Occurrence Handle7713779

  14. 14

    JW Denham LJ Peters J Johansen M Poulsen DS Lamb A Hindley PC O'Brien NA Spry M Penniment H Knawitz S Williamson J Bear L Tripcony (1999) ArticleTitleDo acute mucosal reactions lead to consequential late reactions in patients with head and neck cancer? Radiother Oncol 52 157–164 Occurrence Handle10.1016/S0167-8140(99)00107-3 Occurrence Handle1:STN:280:DC%2BD3c%2FktlKmsg%3D%3D Occurrence Handle10577701

  15. 15

    YV Kapila WJ Dodds JF Helm WJ Hogan (1984) ArticleTitleRelationship between swallow rate and salivary flow. Dig Dis Sci 29 528–533 Occurrence Handle1:STN:280:BiuB3cjktFQ%3D Occurrence Handle6723485

  16. 16

    PU Huguenin D Taussky K Moe A Meister B Baumert UM Lutolf C Glanzman (1999) ArticleTitleQuality of life in patients cured from a carcinoma of the head and neck by radiotherapy: the importance of target volume. Int J Radiat Oncol Biol Phys 45 47–52 Occurrence Handle10.1016/S0360-3016(99)00128-5 Occurrence Handle1:STN:280:DyaK1MvgsVKmtw%3D%3D Occurrence Handle10477005

  17. 17

    PJ Lou WP Chen CC Tai (1999) ArticleTitleDelayed irradiation effects on nasal epithelium in patients with nasopharyngeal carcinoma. An ultrastructural study. Ann Otol Rhinol Laryngol 108 474–480 Occurrence Handle1:STN:280:DyaK1M3ms1Onsg%3D%3D Occurrence Handle10335709

  18. 18

    O Ekberg G Nylander (1983) ArticleTitlePharyngeal dysfunction after treatment for pharyngeal cancer with surgery and radiotherapy. Gastrointest Radiol 8 97–104 Occurrence Handle1:STN:280:BiyB3M%2FnsFQ%3D Occurrence Handle6343174

Download references


The authors would like to thank the National Science Council of the Republic of China for financially supporting this research (NSC86-2314-B-002-220).

Author information

Correspondence to Tyng-Guey Wang MD.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Chang, Y., Chen, S., Tak Lui, L. et al. Dysphagia in Patients with Nasopharyngeal Cancer After Radiation Therapy: A Videofluoroscopic Swallowing Study . Dysphagia 18, 135–143 (2003). https://doi.org/10.1007/s00455-002-0096-x

Download citation


  • cNasopharyngeal carcinoma
  • Radiation
  • Swallowing
  • Dysphagia
  • Deglutition
  • Deglutition disorders