Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-26T13:53:41.297Z Has data issue: false hasContentIssue false

Swallowing outcomes following surgical and non-surgical treatment for advanced laryngeal cancer

Published online by Cambridge University Press:  04 November 2013

E Burnip
Affiliation:
Speech and Language Therapy Department, Sunderland Royal Hospital, UK
S J Owen
Affiliation:
Speech and Language Therapy Department, Freeman Hospital, Newcastle upon Tyne, UK
S Barker
Affiliation:
Speech and Language Therapy Department, Sunderland Royal Hospital, UK
J M Patterson*
Affiliation:
Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK
*
Address for correspondence: Dr J Patterson, Institute for Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK E-mail: [email protected]

Abstract

Background:

Treatment for advanced laryngeal cancer includes surgery, and/or chemoradiotherapy or radiotherapy. Each of these treatments results in major changes to the swallowing mechanism. Dysphagia is strongly correlated with poorer quality of life. A good understanding of outcomes is needed for well-informed treatment decisions.

Method:

This study reports on patients' swallowing outcomes following surgical and non-surgical treatments based on the results of three different swallowing tests. A total of 123 data sets were collected in out-patient clinics across two hospitals in North East England.

Results:

There were no significant differences between treatment groups for patient-reported swallowing outcomes or swallowing performance. However, patients who had undergone chemoradiotherapy or radiotherapy (with or without laryngectomy) had significantly more diet restrictions than other groups.

Conclusion:

Long-term dysphagia is a common outcome of treatment for advanced laryngeal cancer. Patients treated with chemoradiotherapy and laryngectomy reported the worst overall outcomes. More longitudinal prospective research with large treatment groups is needed to investigate swallowing outcomes following different treatment methods.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Hillman, RE, Walsh, MJ, Wolf, GT, Fisher, SG, Hong, WK. Functional outcomes following treatment for advanced laryngeal cancer. Part I–Voice preservation in advanced laryngeal cancer. Part II–Laryngectomy rehabilitation: the state of the art in the VA System. Research Speech-Language Pathologists. Department of Veterans Affairs Laryngeal Cancer Study Group. Ann Otol Rhinol Laryngol Suppl 1998;172:127Google ScholarPubMed
2Lefebvre, JL, Ang, KK; Larynx Preservation Consensus Panel. Larynx preservation clinical trial design: key issues and recommendations – a consensus panel summary. Head Neck 2009;31:429–41CrossRefGoogle ScholarPubMed
3Lovell, SJ, Wong, HB, Loh, KS, Ngo, RY, Wilson, JA. Impact of dysphagia on quality-of-life in nasopharyngeal carcinoma. Head Neck 2005;10:864–72CrossRefGoogle Scholar
4Wilson, JA, Carding, PN, Patterson, JM. Dysphagia after nonsurgical head and neck cancer treatment: patients' perspectives. Otolaryngol Head Neck Surg 2011;145:767–71CrossRefGoogle ScholarPubMed
5Maclean, J, Cotton, S, Perry, A. Post-laryngectomy: it's hard to swallow. Dysphagia 2009;2:172–9CrossRefGoogle Scholar
6Keereweer, S, de Wilt, JHW, Sewnaik, A, Meeuwis, CA, Tilanus, HW, Kerrebijn, JD. Early and long-term morbidity after total laryngopharyngectomy. Eur Arch Otorhinolaryngol 2010;267:1437–44CrossRefGoogle ScholarPubMed
7Logemann, JA, Pauloski, BR, Rademaker, AW, Lazarus, C, Gaziano, J, Stachowiak, L et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck 2008;30:148–58CrossRefGoogle ScholarPubMed
8Hutcheson, KA, Barringer, DA, Rosenthal, DI, May, AH, Roberts, DB, Lewin, JS. Swallowing outcomes after radiotherapy for laryngeal carcinoma. Arch Otolaryngol Head Neck Surg 2008;134:178–83CrossRefGoogle ScholarPubMed
9Langerman, A, MacCracken, E, Kasza, K, Haraf, DJ, Vokes, EE, Stenson, KM. Aspiration in chemoradiated patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2007;133:1289–95CrossRefGoogle ScholarPubMed
10Dworkin, JP, Hill, SL, Stachler, RJ, Meleca, RJ, Kewson, D. Swallowing function outcomes following nonsurgical therapy for advanced-stage laryngeal carcinoma. Dysphagia 2006;21:6674CrossRefGoogle ScholarPubMed
11Terrell, JE, Ronis, DL, Fowler, KE, Bradford, CR, Chepeha, DB, Prince, ME et al. Clinical predictors of quality of life in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2004;130:401–8CrossRefGoogle ScholarPubMed
12Fung, K, Lyden, TH, Lee, J, Urba, SG, Worden, F, Eisbruch, A et al. Voice and swallowing outcomes of an organ-preservation trial for advanced laryngeal cancer. Int J Radiat Oncol Biol Phys 2005;63:1395–9CrossRefGoogle ScholarPubMed
13Lazarus, C, Logemann, JA, Shi, G, Kahrilas, P, Pelzer, H, Kleinjan, K. Does laryngectomy improve swallowing after chemoradiotherapy? A case study. Arch Otolaryngol Head Neck Surg 2002;128:54–7CrossRefGoogle ScholarPubMed
14Jensen, K, Bonde Jensen, A, Grau, C. The relationship between observer-based toxicity scoring and patient assessed symptom severity after treatment for head and neck cancer. A correlative cross sectional study of the DAHANCA toxicity scoring system and the EORTC quality of life questionnaires. Radiother Oncol 2006;78:298305CrossRefGoogle ScholarPubMed
15Patterson, JM, Hildreth, A, McColl, E, Carding, PN, Hamilton, D, Wilson, JA. The clinical application of the 100 ml water swallow test in head and neck cancer. Oral Oncol 2011;47:180–4CrossRefGoogle Scholar
16List, MA, Mumby, P, Haraf, D, Siston, A, Mick, R, MacCracken, E et al. Performance and quality of life outcome in patients completing concomitant chemoradiotherapy protocols for head and neck cancer. Qual Life Res 1997;6:274–84CrossRefGoogle ScholarPubMed
17Chen, AY, Frankowski, R, Bishop-Leone, J, Hebert, T, Leyk, S, Lewin, J et al. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson Dysphagia Inventory. Arch Otolaryngol Head Neck Surg 2001;127:870–6Google ScholarPubMed
18Hughes, TA, Wiles, CM. Clinical measurement of swallowing in health and in neurogenic dysphagia. QJM 1996;89:109–16CrossRefGoogle ScholarPubMed
19Patterson, JM, McColl, E, Carding, PN, Kelly, C, Wilson, JA. Swallowing performance in patients with head and neck cancer: a simple clinical test. Oral Oncol 2009;45:904–7CrossRefGoogle ScholarPubMed
20Logemann, JA, Rademaker, A, Pauloski, BR, Lazarus, C, Mittal, BB, Brockstein, B et al. Site of disease and treatment protocol as correlates of swallowing function in patients with head and neck cancer treated with chemoradiation. Head Neck 2005;28:6473CrossRefGoogle Scholar
21Frowen, J, Cotton, S, Corry, J, Perry, A. Impact of demographics, tumor characteristics, and treatment factors on swallowing after (chemo)radiotherapy for head and neck cancer. Head Neck 2009;32:513–28CrossRefGoogle Scholar
22Lazarus, CL, Logemann, JA, Pauloski, BR, Rademaker, AW, Larson, CR, Mittal, BB et al. Swallowing and tongue function following treatment for oral and oropharyngeal cancer. J Speech Lang Hear Res 2000;43:1011–23CrossRefGoogle ScholarPubMed
23Wu, MC, Chang, YC, Wang, TG, Lin, LC. Evaluating swallowing dysfunction using a 100-ml water swallowing test. Dysphagia 2004;19:43–7Google ScholarPubMed
24Szczesniak, MM, Maclean, J, Cotton, S, Cook, IJ, Perry, A. Videomanometric evaluation of dysphagia following total laryngectomy. J Gastroenterol Hepatol 2009;24:A343Google Scholar
25Francis, DO, Weymuller, EA, Parvathaneni, U, Merati, AL, Yueh, B. Dysphagia, stricture, and pneumonia in head and neck cancer patients: does treatment modality matter? Ann Otol Rhinol Laryngol 2010;119:391–7CrossRefGoogle ScholarPubMed
26Allal, AS, Dulguerov, P, Bieri, S, Lehmann, W, Kurtz, JM. Assessment of quality of life in patients treated with accelerated radiotherapy for laryngeal and hypopharyngeal carcinomas. Head Neck 2000;22:288–933.0.CO;2-B>CrossRefGoogle ScholarPubMed
27Agarwal, J, Dutta, D, Palwe, V, Gupta, T, Laskar, SG, Budrukkar, A et al. Prospective subjective evaluation of swallowing function and dietary pattern in head and neck cancers treated with concomitant chemo-radiation. J Cancer Res Ther 2010;6:1521CrossRefGoogle ScholarPubMed
28Feng, FY, Kim, HM, Lyden, TH, Haxer, MJ, Worden, FP, Feng, M et al. Intensity-modulated chemoradiotherapy aiming to reduce dysphagia in patients with oropharyngeal cancer: clinical and functional results. J Clin Oncol 2010;28:2732–8CrossRefGoogle ScholarPubMed
29Oozeer, NB, Owen, S, Perez, BZ, Jones, G, Welch, AR, Paleri, V. Functional status after total laryngectomy: cross-sectional survey of 79 laryngectomees using the Performance Status Scale for Head and Neck Cancer. J Laryngol Otol 2010;124:412–16CrossRefGoogle ScholarPubMed
30de Casso, C, Slevin, NJ, Homer, JJ. The impact of radiotherapy on swallowing and speech in patients who undergo total laryngectomy. Otolaryngol Head Neck Surg 2008;139:792–7CrossRefGoogle ScholarPubMed
31Gillespie, MB, Brodsky, MB, Day, TA, Lee, FS, Martin-Harris, B. Swallowing-related quality of life after head and neck cancer treatment. Laryngoscope 2004;114:1362–7CrossRefGoogle ScholarPubMed
32LoTempio, MM, Wang, KH, Sadeghi, A, Delacure, MD, Juillard, GF, Wang, MB. Comparison of quality of life outcomes in laryngeal cancer patients following chemoradiation vs. total laryngectomy. Otolaryngol Head Neck Surg 2005;132:948–53CrossRefGoogle ScholarPubMed