Dysphagia, trismus and speech impairment following radiation-based treatment for advanced stage oropharyngeal carcinoma: a one-year prospective evaluation
Karsten, Rebecca T.; Chargi, Najiba; van der Molen, Lisette; van Son, Rob J.J.H.; de Bree, Remco; Al-Mamgani, Abrahim; de Boer, Jan P.; Hilgers, Frans J.M.; van den Brekel, Michiel W.M.; Smeele, Ludi E.; Stuiver, Martijn M.
(2022) European Archives of Oto-Rhino-Laryngology, volume 279, issue 2, pp. 1003 - 1027
(Article)
Abstract
Objective: The objective was to assess swallowing, mouth opening and speech function during the first year after radiation-based treatment (RT(+)) after introduction of a dedicated preventive rehabilitation program for stage III–IV oropharyngeal carcinoma (OPC). Methods: Swallowing, mouth opening and speech function were collected before and at six- and twelve-month follow-up
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after RT(+) for OPC as part of ongoing prospective assessments by speech-language pathologists. Results: Objective and patient-perceived function deteriorated until 6 months and improved until 12 months after treatment, but did not return to baseline levels with 25%, 20% and 58% of the patients with objective dysphagia, trismus and speech problems, respectively. Feeding tube dependency and pneumonia prevalence was low. Conclusion: Despite successful implementation, a substantial proportion of patients still experience functional limitations after RT(+) for OPC, suggesting room for improvement of the current rehabilitation program. Pretreatment sarcopenia seems associated with worse functional outcomes and might be a relevant new target for rehabilitation strategies.
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Keywords: Chemoradiotherapy, Dysphagia, Oropharyngeal carcinoma, Radiotherapy, Sarcopenia, Speech, Trismus, Otorhinolaryngology
ISSN: 0937-4477
Publisher: Springer Verlag
Note: Funding Information: We would like to acknowledge the speech-language pathologists at our institute Anne Kornman, Merel Latenstein, Klaske van Sluis, and Nadya van Gent for the data collection. Jasmine de Jong is acknowledged for her contribution to building the database. The Netherlands Cancer Institute receives a research grant from Atos Medical Sweden, which contributes to the existing infrastructure for health-related, quality-of-life research in the Department of Head and Neck Oncology and Surgery. Funding Information: We would like to acknowledge the speech-language pathologists at our institute Anne Kornman, Merel Latenstein, Klaske van Sluis, and Nadya van Gent for the data collection. Jasmine de Jong is acknowledged for her contribution to building the database. The Netherlands Cancer Institute receives a research grant from Atos Medical Sweden, which contributes to the existing infrastructure for health-related, quality-of-life research in the Department of Head and Neck Oncology and Surgery. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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