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

Asian Pac J Cancer Prev. 2019 Jan 25;20(1):91-96. doi: 10.31557/APJCP.2019.20.1.91.

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.

Keywords: Swallow; quality of life; induction chemotherapy; head and neck cancer.

MeSH terms

  • Chemoradiotherapy / adverse effects*
  • Deglutition Disorders / etiology
  • Deglutition Disorders / prevention & control*
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Induction Chemotherapy*
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Quality of Life*
  • Surveys and Questionnaires