Deglutition disorders as a consequence of head and neck cancer therapies: a systematic review and meta-analysis
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In this study, we aimed to estimate the frequency of deglutition disorders in patients pre- and post-treatment for head and neck cancer (HNC).
Search strategies were developed for the following databases: LILACS, PubMed, SpeechBITE, LIVIVO, Web of Science, and Scopus. Additionally, the gray literature was searched using Google Scholar, OpenGrey, and ProQuest. Only studies that conducted an evaluation of deglutition before and after cancer treatment and had sufficient quantitative data were included. We conducted a proportion of random effects meta-analysis using R statistical software.
Seventeen studies were included. Aspiration showed a high frequency in the period less than 3 months post-treatment, with 28.6% (total sample = 229). Penetration of fluids above the vocal folds and reduced laryngeal elevation were more frequent in the period less than 6 months post-treatment.
The frequency of deglutition disorders and its complications, such as aspiration, appears to be higher in the immediate to 6-month post-treatment period in patients with HNC. The parameter pharyngeal residue continued to increase through the period analyzed.
KeywordsDeglutition disorders Head and neck cancer Chemotherapy Radiation therapy
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Isabela Porto de Toledo is supported by CNPq (Brazilian National Council for Scientific and Technological Development). Letícia Lopes Quirino Pantoja was supported by CAPES (Coordination for the Improvement of Higher Education Personnel), Ministry of Education, Brazil.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 15.Serel S, Demir N, Karaduman AA, Cengiz M, Yakut Y (2013) Head and neck cancer: changes in artrokinematic parameters of neck and swallowing function after radiotherapy. UHOD 27:97–103Google Scholar
- 17.Van der Molen L, Heemsbergen WD, de Jong R et al (2013) Dysphagia and trismus after concomitant chemo-intensity-Modulated Radiation Therapy (chemo-IMRT) in advanced head and neck cancer; dose-effect relationships for swallowing and mastication structures. Radiother Oncol 106:364–369CrossRefGoogle Scholar
- 19.Porto de Toledo I, Pantoja LLQ, Luchesi K, Assad DX, De Luca Canto G, Guerra ENS (2017) Deglutition disorders as a consequence of cancer therapies: a systematic review and meta-analysis. PROSPERO CRD42017067837. Available from: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017067837. Accessed 17 November 2017
- 22.Joanna Briggs Institute (2014) Joanna Briggs institute reviewers’ manual: 2014 edition. The systematic review of prevalence and incidence data. The University of Adelaide: The Joanna Briggs Institute p 37Google Scholar
- 23.Deeks JJ, Bossuyt PM, Gatsonis C, eds (2009) Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Version 1.0. The Cochrane CollaborationGoogle Scholar
- 24.Higgins JPT, Green S (eds) (2011) Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Available from: www.cochrane-handbook.org
- 25.Agarwal J, Palwe V, Dutta D, Gupta T, Laskar SG, Budrukkar A, Murthy V, Chaturvedi P, Pai P, Chaukar D, D’Cruz AK, Kulkarni S, Kulkarni A, Baccher G, Shrivastava SK (2011) Objective assessment of swallowing function after definitive concurrent (chemo)radiotherapy in patients with head and neck cancer. Dysphagia 26:399–406CrossRefGoogle Scholar
- 27.Eisbruch A, Lyden T, Bradford CR, Dawson LA, Haxer MJ, Miller AE, Teknos TN, Chepeha DB, Hogikyan ND, Terrell JE, Wolf GT (2002) Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head-and-neck cancer. Int J Radiat Oncol Biol Phys 53:23–28CrossRefGoogle Scholar
- 32.Logemann JA, Rademaker AW, Pauloski BR, Lazarus CL, Mittal BB, Brockstein B, MacCracken E, Haraf DJ, Vokes EE, Newman LA, Liu D (2006) Site of disease and treatment protocol as correlates of swallowing function in patients with head and neck cancer treated with chemoradiation. Head Neck 28:64–73CrossRefGoogle Scholar
- 35.Xinou E, Chryssogonidis I, Kalogera-Fountzila A, Panagiotopoulou-Mpoukla D, Printza A (2018) Longitudinal evaluation of swallowing with videofluoroscopy in patients with locally advanced head and neck cancer after chemoradiation. [published ahead of print March 23, 2018]. Dysphagia. https://doi.org/10.1007/s00455-018-9889-4
- 37.Haidich AB (2010) Meta-analysis in medical research. Hippokratia 14:29–37Google Scholar
- 38.Rinkel RN, Verdonck-de Leeuw IM, Doornaert P, Buter J, de Bree R, Langendijk JA, Aaronson NK, Leemans CR (2016) Prevalence of swallowing and speech problems in daily life after chemoradiation for head and neck cancer based on cut-off scores of the patient-reported outcome measures SWAL-QOL and SHI. Eur Arch Otorhinolaryngol 273:1849–1855CrossRefGoogle Scholar