Long‐term functional and survival outcomes after induction chemotherapy and risk‐based definitive therapy for locally advanced squamous cell carcinoma of the head and neck. Issue 4 (18th June 2013)

• Record Type: Journal Article
• Authors: Hutcheson, Katherine A.; Lewin, Jan S.; Holsinger, F. Christopher; Steinhaus, Ganene; Lisec, Asher; Barringer, Denise A.; Lin, Heather Y.; Villalobos, Sandra; Garden, Adam S.; Papadimitrakopoulou, Vali; Kies, Merrill S.
• Is Part Of: Head & neck. Volume 36:Issue 4(2014:Apr.)
• Page Start: 474
• Page End: 480
• Publication Date: 2013-06-18
• Subjects: Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.23330
• Languages: English
• ISSNs: 1043-3074

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hed23330-sec-0001" sec-type="section"> <title>Background</title> <p>The purpose of this study was to evaluate long‐term outcomes after induction chemotherapy followed by "risk‐based" local therapy for locally‐advanced squamous cell carcinoma of the head and neck (SCCHN).</p> </sec> <sec id="hed23330-sec-0002" sec-type="section"> <title>Methods</title> <p>Forty‐seven patients (stage IV; ≥N2b) were enrolled in a phase II trial. Baseline and 24‐month functional measures included modified barium swallow (MBS) studies, oropharyngeal swallow efficiency (OPSE), and the MD Anderson Dysphagia Inventory (MDADI). Functional status was assessed at 5 years.</p> </sec> <sec id="hed23330-sec-0003" sec-type="section"> <title>Results</title> <p>Five‐year overall survival (OS) was 89% (95% confidence interval [CI], 81% to 99%). A nonsignificant 13% average reduction in swallowing efficiency (OPSE) was observed at 24 months relative to baseline (<italic>p</italic> = .191). MDADI scores approximated baseline at 24 months. Among 42 long‐term survivors (median, 5.9 years), 3 patients (7.1%) had chronic dysphagia. The rate of final gastrostomy dependence was 4.8% (2 of 42).</p> </sec> <sec id="hed23330-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Sequential chemoradiotherapy achieved favorable outcomes among patients with locally advanced SCCHN, mainly of oropharyngeal origin. MBS and MDADI scores found modest swallowing deterioration at 2 years, and chronic aspiration was uncommon in long‐term survivors. © 2013 Wiley Periodicals, Inc. <italic>Head Neck</italic><bold>36</bold>: 474–480, 2014</p> </sec> </abstract>