Speech, Swallowing Usually OK After Head & Neck Cancer Therapy
Posted Dec 20 2010 4:00pm
Most patients had no lasting problems 3 years after chemoradiotherapy, study finds
By Robert Preidt
Monday, December 20, 2010
MONDAY, Dec. 20 (HealthDay News) -- Most head and neck cancer patients can speak and swallow after undergoing combined chemotherapy and radiation treatment, but several factors may be associated with poor outcomes, researchers have found.
The new study included patients who were assessed nearly three years after they were successfully treated with chemoradiotherapy for advanced head and neck cancer.
The U.S. researchers gave a speaking score of 1 through 4 to 163 patients an average of 34.8 months after they completed treatment, and gave a swallowing score of 1 through 4 to 166 patients an average of 34.5 months after treatment. A higher score indicated reduced ability to speak or swallow.
Most of the patients (84.7 percent of those assigned speaking scores and 63.3 percent of those given swallowing scores) had no lasting problems and received a score of 1. Of the 160 patients who were given both speaking and swallowing scores, 96 had a score of 1 in each category, the investigators found.
Factors associated with poorer speaking ability were: being female; a history of smoking; a tumor in the hypopharynx (where the larynx and esophagus meet) or the larynx; or having a tumor that did not respond to the initial dose of chemotherapy.
Factors associated with poorer swallowing ability were: being older; have poor swallowing ability before treatment; neck dissection (surgery to remove lymph nodes and surrounding tissue); and having a tumor in the hypopharynx or larynx.
Dr. Kent Mouw, who was at the University of Chicago at the time of the study and is now at Brigham and Women's Hospital in Boston, and colleagues published their findings in the December issue of the journal Archives of Otolaryngology -- Head & Neck Surgery.
"One of the remarkable features of the data is that most of the patients experienced minimal residual speech or swallowing deficits. Although differences . . . may exist between these patients and healthy subjects, it is encouraging to note that, when day-to-day activities are used as a metric, most patients experience a return to normal or near-normal function," Mouw and colleagues wrote in a journal news release. "Because advances in therapy have led to improved survival in these patients, understanding and controlling adverse effects of treatment should continue to be an active area of investigation," the authors concluded.