Factors associated with swallowing dysfunction in patients with head and neck cancer

Abstract

Background:The aim of this prospective cohort study was to investigate swallowing function in relation to personal and clinical factors among patients with head and neck cancer (HNC) from diagnosis up to 2 years after treatment. Methods:The 100 ml water swallow test was measured before treatment, and 3, 6, 12, and 24 months after treatment. Linear mixed-effects model analysis was conducted to investigate changes over time and the association with personal (sex and age) and clinical (tumor site, tumor stage, and treatment modality) factors.Results: Among 128 included patients, number of swallows increased from baseline to 3 months after treatment and decreased to baseline again at 6 months after treatment. The number of swallows was associated with age and treatment modality. Conclusions:In patients with HNC, swallowing (dys)function changes over time with the worst score 3 months after treatment. A higher age and being treated with surgery are factors associated with swallowing dysfunction over time. K E Y W O R D S100 ml water swallowing test, head and neck cancer, linear mixed model, swallowing dysfunctionThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Unravelling Quality of Life for Head and Neck Cancer Patients after VMAT Radiation Therapy: Insights from Toxicity, Dosimetry and Symptoms Correlation

“…Patients reported a significant reduction in symptoms such as pain, swallowing difficulties, and dry mouth following completion of VMAT radiation therapy ( Figure 3 ). These findings align with previous studies indicating that the Overall Health Index of patients is increasing over the course of treatment while the symptom burden tends to decrease post-treatment as acute side effects subside and patients adjust to long-term sequelae [ 4 , 20 , 21 , 22 , 23 ].…”

Swallowing after Oral Oncological Treatment: A Five-Year Prospective Study

“…Treatment with surgery and adjuvant radiotherapy was associated with a higher WSF and ASF than surgery alone, which is in accordance with the findings of a previous crosssectional study on swallowing ability [33] but was not found in a two-year prospective cohort study, which is possibly related to the broader patient group of HNC instead of focusing only on oral cancer [17]. Fibrosis, xerostomia, mucositis, and neuropathy caused by radiotherapy may lead to impaired oral compliance and contractility of swallowingrelated musculature [34], affecting WSF and ASF.…”

“…In this study, patient age influenced WSD, WSF, ASD, and ASF; the older the patient, the worse the outcome. In a 2-year prospective cohort study in patients with HNC, this was also found for WSF by using the 100 mL water swallow test [17]. Aging is one of the main risk factors for swallowing dysfunction, as neuromuscular impairments of the swallowing-related structures may occur [8,[24][25][26].…”

“…Insight into factors associated with swallowing function like duration and frequency of swallowing in patients treated for oral cancer is of importance to facilitate its management before and after oral oncological treatment. Previous prospective studies have analyzed swallowing function and its associated factors (e.g., age, gender, location of the tumor, treatment protocol) but only up to 2 years after HNC treatment [12][13][14][15][16][17]. It is of importance to know what the swallow function is in long-term survivors, as this can give us as clinicians information to improve swallowing rehabilitation and therefore improve the patient's quality of life.…”