Swallowing disorders after treatment for head and neck cancer
Abstract
Background. Dysphagia is a common consequence of treatment for head and neck cancer (HNC). The purpose of this study was to evaluate the prevalence of dysphagia in a group of patients treated for HNC in Slovenia, and to identify factors contributing to the development of dysphagia.
Methods. One-hundred-nine consecutive patients treated for HNC at two tertiary centers were recruited during their follow-up visits. They fulfilled EORTC QLQ-H&N35 and “Swallowing Disorders after Head and Neck Cancer Treatment questionnaire” questionnaires. Patients with dysphagia were compared to those without it.
Results. Problems with swallowing were identified in 41.3% of the patients. Dysphagia affected their social life (in 75.6%), especially eating in public (in 80%). Dysphagia was found the most often in the patients with oral cavity and/or oropharyngeal cancer (in 57.6%) and in those treated less than 2 years ago (p=0.014). On univariate analysis, a significant relationship was observed between dysphagia prevalence and some of the consequences of anti-cancer treatment (impaired mouth opening, sticky saliva, loss of smell, impaired taste, oral and throat pain, persistent cough, and hoarseness), radiotherapy (p=0.003), and symptoms of gastroesophageal reflux (p=0.027). After multiple regression modelling only persistent cough remained significantly connected with dysphagia (p=0.023).
Conclusions. In order to improve swallowing abilities and, consequently, quality of life of the patients with HNC a systematic rehabilitation of swallowing should be organized. A special emphasis should be given to gastroesophageal reflux treatment before, during and after therapy for HNC.
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Radiology and Oncology (ISSN 1318-2099) is a multidisciplinary journal devoted to-the publishing of original and high quality articles in diagnostic and interventional radiology, computerized tomography, ultrasound, magnetic resonance, nuclear medicine, radiotherapy, clinical and experimental oncology, radiobiology, radiophysics, and radiation protection. Therefore, the scope of the journal is to cover beside radiology diagnostic and therapeutic aspects in oncology, which distinguishes it from other journals in the field.
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