The aim of this study was to assess patients' perspectives on swallowing outcomes, i.e., severity, time, and course before and after nonsurgical intervention for head and neck cancer. There were 167 participants: 66 (39%) oropharynx, 21 (13%) hypopharynx, 63 (38%) larynx, 5 (3%) nasopharynx, and 12 (7%) unknown primary. All were administered and completed the MD Anderson Dysphagia Index (MDADI) and the University of Washington Quality of Life Questionnaire (UWQOL) before treatment and at 3, 6, and 12 months after treatment. Treatment schedules were (1) chemoradiotherapy with cisplatin 40 mg/m~2 in six cycles combined with 63 Gy in 30 fractions at 2.1 Gy/fraction over 6 weeks, (2) 63 Gy in 30 fractions over 6 weeks, or (3)50 Gy in 16 fractions at 3.1 Gy/fraction over 22 days. All patients had three-dimensional conformal treatment and none received intensity-modulated radiation therapy. There was a sharp deterioration in swallowing, i.e., 18% for pre-treatment versus 3 months post-treatment, regardless of treatment schedule. This was followed by little improvement over the next 3-12 months.
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