A Swallow Preservation Protocol Improves Function for Veterans Receiving Chemoradiation for Head and Neck Cancer. (2nd September 2014)

• Record Type: Journal Article
• Authors: Peng, Kevin A.; Wu, Edward C.; Unger, Lindsay; Lorentz, William; Wang, Marilene B.; Long, Jennifer L.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 151(2014)Supplement 1
• Page Start: P66
• Page End: P66
• Publication Date: 2014-09-02
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814541627a118
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: Determine the efficacy of a swallowing preservation protocol on maintaining swallow function in patients undergoing chemoradiation (CRT) for head and neck squamous cell carcinoma (HNSCC). Methods: Retrospective case‐control study of patients treated with CRT for HNSCC between July 2011 and December 2013 at a Veterans Affairs medical center. The study group comprised patients participating in a swallowing preservation protocol, including swallowing exercises and biweekly follow‐up, during CRT. The control group received no swallowing intervention during CRT. A previously described functional outcomes of swallowing scale (FOSS; 0 = no symptoms and 5 = nonoral feeding for all nutrition) was used to quantify dysphagia prior to, at the completion of, and 2 months following the completion of CRT. Results: Forty‐eight (all male; mean age, 67 years) and 85 patients (all male; mean age, 61 years) were included in the swallowing preservation and control groups, respectively. In the swallowing preservation group, mean pre‐ and posttreatment FOSS scores were 2.2 and 1.9, respectively, while the corresponding scores in the control group were 0.92 and 1.0. This approached statistical significance (Fisher's exact test, P =. 2). Conclusions: Patients enrolled in a swallow preservation protocol had overall poorer swallowing function at the initiation of CRT, but compared to the control group, a higher fraction of patients in the swallowing preservation protocol maintained or improved their swallow at posttreatment follow‐up. This confirms the importance of early evaluation and intervention for dysphagia prior to and during CRT.