Study of Dysphagia in Patients with Advanced Oropharyngeal Cancer Subjected to an Organ Preservation Protocol Based on Concomitant Radiotherapy and Chemotherapy

摘要

Introduction: Organ preservation protocol (based on chemo-radiotherapy) for oropharyngeal tumors includedysphagia as a possible sequel leading to function impairment and changes in patient’s quality of life. Objectives:The aim of this study is to assess dysphagia severity after treatment in advanced oropharyngeal cancer patients treatedwith concurrent chemo-radiation. Methods: This prospective cross-sectional study included 64 participants whohad been disease free for at least six months after primary treatment. Dysphagia severity was assessed by fibre-opticendoscopic evaluation of swallowing (FEES) and the Dysphagia Outcome and Severity Scale (DOSS); the occurrenceof penetration/aspiration during swallowing was also investigated. All participants also completed the M. D. AndersonDysphagia Inventory (MDADI). The correlation of FEES results with clinical-demographic variables and MDADIscores was assessed. Descriptive analysis was performed, and qualitative variables were compared using either thechi-square or Fisher’s exact test. Results: FEES revealed silent aspiration in 18.8% of the patients. Approximately 6.3%of the patients exhibited severe dysphagia (scores 1-2 in DOSS). Dysphagia severity was significantly associated withthe MDADI physical domain scores. The participants with scores 5-7 in DOSS (no or mild dysphagia) exhibited lesslimitations in the MDADI physical domain (p=0.015). Conclusions: Silent aspiration was detected in one of every fivepatients treated with concurrent chemo-radiotherapy; almost half of the patients exhibit at least moderate dysphagia.Assessment of the participant’s quality of life via the MDADI revealed an association between the physical domainscores and dysphagia severity.