Self-evaluation of the dysphagia symptoms by EAT-10 before the onset of the radio(chemo)therapy in head-and-neck cancer patients

Introduction:

Aspiration and limitation of oral intake, that is, dysphagia with the need for further intervention (DFI), can occur in head-and-neck cancer patients already before the onset of the oncological therapy. The study presented here scrutinized to what extent such patients are aware of their swallowing disorder.

Methods:

In the years 2015 – 2017, 49 head-and-neck cancer patients (76% male; age 42 – 81 years, median 63, UICC stages I-IV) were included in the study. The patients' swallowing functions were assessed by FEES® diagnostics. On the basis of FEES® results, the severity of penetration/aspiration was determined by Rosenbek's scale (PAS), the limitation of oral intake by Crary's FOIS scale, and DFI was determined under consideration of both scales. All patients filled out the questionnaire EAT-10 to self-evaluate their swallowing disorder.

Results:

According to FEES®, 35% of patients demonstrated DFI, 14% aspirated, and in 8% silent aspiration was found. Limitations of oral intake were identified in 20% of the sample, these patients were nourished by means of stomach tubes.

The median of the EAT-10 total score amounted to 11.0, the medians of single questionnaire items ranged between 0 and 1.

Higher total scores of EAT-10 were significantly associated with the “fail” result on the FOIS and DFI scales (Z = -3.8; Z = -2.4; p ≤0.015). In case of PAS, no significant association was found.

Conclusions:

The patients' self-evaluation of limitation of oral intake can be considered reliable. This was less often valid for the dysphagia with the need for further intervention. For aspiration, the self-evaluation demonstrated very unreliable results.

Publication History

Publication Date:
18 April 2018 (online)