Translational Research for Rehabilitation of Swallowing in Head and Neck Cancer Patients

  • Uttam K. Sinha


Patients with head and neck cancer (HNC) suffer from difficulty in swallowing termed dysphagia due to the disease process itself and surgical and nonsurgical treatment of cancer [1]. Dysphagia has a most detrimental influence on quality of life (QOL) [2, 3]. Also, an estimated 65–88% of patients with dysphagia have several episodes of silent aspiration. This is a potentially fatal complication [4, 5]. A large number of predictive factors of swallowing function have been identified in multiple studies. They can be treatment-related factors (concurrent chemoradiation therapy (CRT), accelerated radiotherapy (RT), bilateral neck treatment [6], non-conformal RT [7], RT treatment field length [8, 9] and volume [10]), patient-related factors (baseline dysphagia, odynophagia, acute mucositis, xerostomia [11]), or tumor-related factors (advanced T-stage [6, 7], clinical stage IV [11], and tumor site [oropharynx] [6]. In the interest of survival improvement, modifications of the conventional RT have included concurrent chemotherapy (CT) and altered fractionated RT, particularly accelerated regimens [12, 13]. These strategies increase the tumoricidal effects of RT [14]. Nevertheless, the radiation-sensitizing effects of CT have been shown to result in increased acute problems like mucositis and late complications like fibrosis and stenosis [15]. These problems of C/RT have recently been acknowledged as one of the main hurdles to winning the fight against HNC [16].



The current work was supported by the National Institute on Deafness and Other Communication Disorders (NIDCD), Watt Family Endowed Chair, and Whittier Foundation. The author would like to thank Brenda Villegas, MS, CCC-SLP; Melody Ouyoung, MS, CCC-SLP; Yihe Zu, MD, PhD; Rizwan Masood, PhD; Srikanth Narayanan, PhD; and Gerald Loeb, MD, for their contribution in dysphagia research.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Uttam K. Sinha
    • 1
  1. 1.Department of Head and Neck SurgeryKeck Medical Center, University of Southern CaliforniaLos AngelesUSA

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