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Dysphagia and Oral Morbidities in Chemoradiation-Treated Head and Neck Cancer Patients

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Abstract

This study prospectively evaluated relationships between oral morbidities and swallowing ability in head/neck cancer patients following chemoradiation therapy (CRT) and at 3 months following CRT. Thirty patients with confirmed head/neck cancer undergoing chemoradiation were assessed with a battery of swallowing measures and measures of oral morbidities related to chemoradiation (xerostomia, mucositis, pain, taste/smell, oral moisture). All measures were completed at baseline (within the first week of CRT), at 6 weeks (end of treatment), and at 3 months following chemoradiation. Descriptive and univariate statistics were used to depict change over time in swallowing and each oral morbidity. Correlation analyses evaluated relationships between swallowing function and oral morbidities at each time point. Most measures demonstrated significant negative change at 6 weeks with incomplete recovery at 3 months. At 6 weeks, mucositis ratings, xerostomia, and retronasal smell intensity demonstrated significant inverse relationships with swallowing function. In addition, oral moisture levels demonstrated significant positive relationships with swallowing function. At 3 months, mucositis ratings maintained a significant, inverse relationship with swallow function. Taste and both orthonasal and retronasal smell intensity ratings demonstrated inverse relationships with measures of swallow function. Swallow functions and oral morbidities deteriorate significantly following CRT with incomplete recovery at 3 months post treatment. Furthermore, different patterns of relationships between swallow function measures and oral morbidities were obtained at the 6-week versus the 3-month assessment point suggesting that different mechanisms may contribute to the development versus the maintenance of dysphagia over the trajectory of treatment in these patients.

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Funding

This study was funded by a grant to Professor Crary from the Florida Department of Health—Bankhead-Coley Cancer Research Program (BB203). Dr. Yoshiaki Ihara’s participation on this project was supported by a Showa University Research Grant for Young Researchers.

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Authors and Affiliations

  1. Swallowing Research Laboratory, Department of Communication Sciences and Disorders, University of Central Florida, 3280 Progress Drive, Suite 500, Orlando, FL, 32826, USA

    Yoshiaki Ihara, Michael A. Crary, David C. Gregorio, Ikjae Im, Sarah E. Ross & Giselle D. Carnaby

  2. Division of Oral Rehabilitation Medicine, Department of Special Needs Dentistry, School of Dentistry, Showa University, Tokyo, Japan

    Yoshiaki Ihara

  3. Department of Communication Sciences and Disorders, College of Health and Human Performance, The Pennsylvania State University, University Park, PA, USA

    Aarthi Madhavan

  4. Graduate Program in Speech-Language Therapy, Chonbuk National University, Jeonju, Republic of Korea

    Ikjae Im

Authors
  1. Yoshiaki Ihara
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  2. Michael A. Crary
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  3. Aarthi Madhavan
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  4. David C. Gregorio
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  5. Ikjae Im
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  6. Sarah E. Ross
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  7. Giselle D. Carnaby
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Correspondence to Michael A. Crary.

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The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the local institutional review board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants including in the study.

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Ihara, Y., Crary, M.A., Madhavan, A. et al. Dysphagia and Oral Morbidities in Chemoradiation-Treated Head and Neck Cancer Patients. Dysphagia 33, 739–748 (2018). https://doi.org/10.1007/s00455-018-9895-6

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  • DOI: https://doi.org/10.1007/s00455-018-9895-6

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