Swallowing capacity of head-and-neck cancer patients before the onset of the radio(chemo)therapy and in the first six months after the onset

Introduction Head-and-neck cancer (HNC) often results in oropharyngeal dysphagia. However, systematic analyses on the development of the swallowing capacity during the radio(chemo)therapy (RCT) are rarely published. The study presented here aimed to examine the aspiration, restrictions of oral intake as well as care relevance (CR) from the time point before the RCT onset to 6 months after it.

Materials and Methods A total of 94 HNC patients were recruited for the study in 2015 – 2019 (age median 63 years). The patients underwent FEES^® diagnostics at four time points – before RCT onset (T1), 1 (T2), 3 (T3), and 6 (T4) months after it – for the assessment of the severity of aspiration (PAS scale by Rosenbek), restrictions of oral intake (FOIS scale by Crary), and CR on the basis of PAS and FOIS.

Changes in all scales were analyzed for T1-T4 by Friedman tests, pairwise comparisons by Wilcoxon tests.

Results Before RCT onset, 35 % of patients had CR, 18 % aspirated, and 9 % had a still aspiration. 22 % had restrictions of oral intake. The values of the PAS, FOIS, and CR scales got worse before T2 but achieved almost the level of T1 before T4. Changes between four test sessions were statistically significant (ps < .05). The same was valid for the following pairwise comparisons: for FOIS and CR T1 and T2, T2 and T3; for FOIS additionally T3 and T4; for PAS only T2 and T3 (ps < .05).

Discussion In the first 6 months after RCT onset, HNC patients demonstrated significant changes in their swallowing capacity. Therefore, a systematic assessment of this capacity constitutes an important element in a successful oncological therapy.

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Deutsche Krebshilfe e.V.

Publication History

Article published online:
10 June 2020