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Longitudinal and long-term effects of radiotherapy on swallowing function after tongue reconstruction

Published online by Cambridge University Press:  17 August 2016

M Fujiki*
Affiliation:
Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Chiba
S Miyamoto
Affiliation:
Division of Plastic and Reconstructive Surgery, National Cancer Center, Tokyo, Japan
S Zenda
Affiliation:
Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba
M Sakuraba
Affiliation:
Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Chiba
*
Address for correspondence: Dr Masahide Fujiki, Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan Fax: +81 3 3545 3567 E-mail: [email protected]

Abstract

Objective:

This study evaluated the longitudinal and long-term effects of radiotherapy on swallowing function after tongue reconstruction.

Methods:

The study comprised 16 patients who had: undergone glossectomy and tongue reconstruction with free flap transfer, received adjuvant radiotherapy, and survived without recurrence for at least 1 year. Swallowing function, as indicated by tolerance of oral intake, was evaluated before radiotherapy, at radiotherapy completion, and at 6 and 12 months after radiotherapy completion.

Results:

Before radiotherapy, all patients could tolerate oral intake. At radiotherapy completion, only three patients could consume all nutrition orally. However, swallowing function improved over time, and by 12 months after radiotherapy completion it had returned nearly to that before radiotherapy.

Conclusion:

Acute dysphagia due to radiotherapy after tongue reconstruction is severe, but can improve gradually. Multidisciplinary support of patients during percutaneous endoscopic gastrostomy dependence is important to improve long-term functional outcomes.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Kimata, Y, Uchiyama, K, Ebihara, S, Saikawa, M, Hayashi, R, Haneda, T et al. Postoperative complications and functional results after total glossectomy with microvascular reconstruction. Plast Reconstr Surg 2000;106:1028–35CrossRefGoogle ScholarPubMed
2 Dziegielewski, PT, Ho, ML, Rieger, J, Singh, P, Langille, M, Harris, JR et al. Total glossectomy with laryngeal preservation and free flap reconstruction: objective functional outcomes and systematic review of the literature. Laryngoscope 2013;123:140–5CrossRefGoogle ScholarPubMed
3 Ruhl, CM, Gleich, LL, Gluckman, JL. Survival, function, and quality of life after total glossectomy. Laryngoscope 1997;107:1316–21Google Scholar
4 Agarwal, J, Palwe, V, Dutta, D, Gupta, T, Laskar, CG, Budrukkar, A et al. Objective assessment of swallowing function after definitive concurrent (chemo)radiotherapy in patients with head and neck cancer. Dysphagia 2011;26:399406 CrossRefGoogle ScholarPubMed
5 Cooper, JS, Pajak, TF, Forastiere, AA, Jacobs, J, Campbell, BH, Saxman, SB et al. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 2004;350:1937–44Google Scholar
6 Mortensen, HR, Overgaard, J, Jensen, K, Specht, L, Overgaard, M, Johansen, J et al. Factors associated with acute and late dysphagia in the DAHANCA 6 & 7 randomized trial with accelerated radiotherapy for head and neck cancer. Acta Oncol 2013;52:1535–42Google Scholar
7 Murphy, BA, Gilbert, J. Dysphagia in head and neck cancer patients treated with radiation: assessment, sequelae, and rehabilitation. Semin Radiat Oncol 2009;19:3542 CrossRefGoogle ScholarPubMed
8 Miyamoto, S, Sakuraba, M, Nagamatsu, S, Kayano, S, Kamizono, K, Hayashi, R. Risk factors for gastric-tube dependence following tongue reconstruction. Ann Surg Oncol 2012;19:2320–6Google Scholar
9 Shin, YS, Koh, YW, Kim, SH, Jeong, JH, Ahn, S, Hong, HJ et al. Radiotherapy deteriorates postoperative functional outcome after partial glossectomy with free flap reconstruction. J Oral Maxillofac Surg 2012;70:216–20CrossRefGoogle ScholarPubMed
10 Sobin, LH, Gospodarowicz, MK, Wittekind, C, eds. TNM Classification of Malignant Tumours, 7th edn. Hoboken, NJ: Wiley-Blackwell, 2009 Google Scholar
11 Clavel, S, Fortin, B, Després, P, Donath, D, Souliéres, D, Khaouam, N et al. Enteral feeding during chemoradiotherapy for advanced head-and-neck cancer: a single-institution experience using a reactive approach. Int J Radiat Oncol Biol Phys 2011;79:763–9CrossRefGoogle ScholarPubMed
12 Deantonio, L, Masini, L, Brambilla, M, Pia, F, Krengli, M. Dysphagia after definitive radiotherapy for head and neck cancer. Correlation of dose-volume parameters of the pharyngeal constrictor muscles. Strahlenther Onkol 2013;189:230–6Google ScholarPubMed
13 Larsson, M, Hedelin, B, Johansson, I, Athlin, E. Eating problems and weight loss for patients with head and neck cancer: a chart review from diagnosis until one year after treatment. Cancer Nurs 2005;28:425–35CrossRefGoogle ScholarPubMed
14 Logemann, JA, Pauloski, BR, Rademaker, AW, Lazarus, CL, Gaziano, J, Stachowiak, L et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck 2008;30:148–58Google Scholar
15 Garden, AS, Harris, J, Trotti, A, Jones, CU, Carrascosa, L, Cheng, JD et al. Long-term results of concomitant boost radiation plus concurrent cisplatin for advanced head and neck carcinomas: a phase II trial of the radiation therapy oncology group (RTOG 99-14). Int J Radiat Oncol Biol Phys 2008;71:1351–5Google Scholar
16 Caudell, JJ, Schaner, PE, Meredith, RF, Locher, JL, Nabell, LM, Carroll, WR et al. Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys 2009;73:410–15Google Scholar
17 Givens, DJ, Karnell, LH, Gupta, AK, Clamon, GH, Pagedar, NA, Chang, KE et al. Adverse events associated with concurrent chemoradiation therapy in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2009;135:1209–17Google Scholar
18 Eisbruch, A, Schwartz, M, Rasch, C, Vineberg, K, Damen, E, Van As, CJ et al. Dysphagia and aspiration after chemoradiotherapy for head-and-neck cancer: which anatomic structures are affected and can they be spared by IMRT? Int J Radiat Oncol Biol Phys 2004;60:1425–39Google Scholar
19 Capuano, G, Grosso, A, Gentile, PC, Battista, M, Bianciardi, F, Di, Palma et al. Influence of weight loss on outcomes in patients with head and neck cancer undergoing concomitant chemoradiotherapy. Head Neck 2008;30:503–8Google Scholar
20 Gourin, CG, Couch, ME, Johnson, JT. Effect of weight loss on short-term outcomes and costs of care after head and neck cancer surgery. Ann Otol Rhinol Laryngol 2014;123:101–10CrossRefGoogle ScholarPubMed
21 Lewis, SL, Brody, R, Touger-Decker, R, Parrott, JS, Epstein, J. Feeding tube use in patients with head and neck cancer. Head Neck 2014;36:1789–95Google Scholar
22 Corry, J, Poon, W, McPhee, N, Milner, AD, Cruickshank, D, Porceddu, SV et al. Prospective study of percutaneous endoscopic gastrostomy tubes versus nasogastric tubes for enteral feeding in patients with head and neck cancer undergoing (chemo)radiation. Head Neck 2009;31:867–76Google Scholar
23 Hutcheson, KA, Bhayani, MK, Beadle, BM, Gold, KA, Shinn, EH, Lai, SY et al. Eat and exercise during radiotherapy or chemoradiotherapy for pharyngeal cancers: use it or lose it. JAMA Otolaryngol Head Neck Surg 2013;139:1127–34CrossRefGoogle ScholarPubMed