Trends in Swallowing Outcomes Following Deintensified Treatment in Selected p16+ Oropharyngeal Carcinoma. Issue 1 (24th March 2023)

• Record Type: Journal Article
• Authors: Lee, Esther; Magge, Hari; Park, Isabel; Shakhtour, Leyn; Li, Ning‐Wei; Schottler, Jennifer; Joshi, Arjun S.; Thakkar, Punam G.; Goodman, Joseph F.
• Is Part Of: OTO open. Volume 7:Issue 1(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2023-03-24
• Subjects: MD Anderson Dysphagia Inventory -- oropharyngeal squamous cell carcinoma -- radiation -- swallowing -- transoral robotic surgery; Otolaryngology -- Periodicals; Otolaryngology; Electronic journals; Periodicals; 617.51
• DOI: 10.1002/oto2.47
• Languages: English
• ISSNs: 2473-974X

Abstract

Abstract: Objective: Identify trends in swallowing outcomes in p16+ oropharyngeal squamous cell carcinoma following neoadjuvant chemotherapy+surgery (NAC+S) versus neoadjuvant chemotherapy+surgery+radiation (NAC+S+R). Study Design: Cohort study. Setting: Single academic institution. Methods: Swallowing outcome was measured using a validated questionnaire, MD Anderson Dysphagia Inventory (MDADI). MDADI scores were compared between NAC+S and NAC+S+R groups in short‐term (<1 year), middle‐term (1‐3 years), and long‐term (>3 years). Clinical factors associated with MDADI scores were explored using a linear mixed model. Statistical significance was established at p < .05. Results: Sixty‐seven patients met the inclusion criteria and were divided into 2 groups: NAC+S (57 [85.1%]) and NAC+S+R (10 [14.9%]). All patients had improved MDADI scores in the middle‐term compared to short‐term (NAC+S: score increase = 3.43, p = .002; NAC+S+R: score increase = 11.18, p = .044), long‐term compared to short‐term (NAC+S: score increase = 6.97, p < .001; NAC+S+R: score increase = 20.35, p < .001), and long‐term compared to middle‐term (NAC+S: score increase = 3.54, p = .043; NAC+S+R: score increase = 9.18, p = .026). NAC+S patients had better MDADI scores than NAC+S+R patients at short‐term (83.80 vs 71.26, p = .001). There was no significant difference in swallowing function in the middle‐term or long‐term. Conclusion: Regardless of treatment type, swallowing will likely be improved in the middle‐term and long‐term compared to the short‐term. Patients treated with NAC+S+R will have worse short‐term swallowing function. However, in the middle‐term and long‐term, there is no significant difference in swallowing function between patients treated with NAC+S and NAC+S+R.