Effect of Induction Chemotherapy on Swallowing in Head and Neck Cancer Patients

Abstract

Objective: To evaluate the effect of induction chemotherapy on swallowing and swallowing-related quality of life<br />of patients with oropharyngeal, laryngeal and hypopharyngeal cancer. Study design: Prospective study of 33 patients<br />with locally advanced tumors who were eligible for treatment with neoadjuvant chemotherapy followed by radiotherapy<br />and concurrent chemotherapy. A multidimensional assessment of swallowing was performed using the following<br />tools: (1) Clinical analysis, numerical scale for general pain and painful swallowing, American Speech and Hearing<br />Association (ASHA) Functional Communication Measures (FCM) swallowing assessment scales, (2) assessment<br />of Swallowing-Related Quality of Life (The MD Anderson Dysphagia Inventory - MDADI), and (3) swallowing<br />videofluoroscopy. Results: There was a reduction in general pain scale (p=0.021), and quality of life (emotional,<br />functional and physical) improved from average limitation (score of 61-80) to minimal limitation (81-100) after<br />induction chemotherapy. According to the swallowing videofluoroscopy results, 26 (78.7%) of the patients had some<br />degree of dysphagia pre-treatment, which decreased to 21 (63.6%) after induction. Conclusion: Our results suggest<br />that induction chemotherapy improves numerous aspects of swallowing and has a positive impact on the quality of<br />life of pre-chemoradiotherapy patients.