Skip to main content

Advertisement

Log in

Trends in Reporting of Swallowing Outcomes in Oropharyngeal Cancer Studies: A Systematic Review

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Over the last two decades, dysphagia is increasingly recognized as a significant short-term and long-term issue in oropharyngeal cancer patients. However, there remains a lack of standardization and agreement about reporting swallowing outcomes in studies that assess treatment outcomes in this population. A systematic review was performed following PRISMA Guidelines by searching Pubmed (MEDLINE) and Scopus. The inclusion criteria used included (1) prospective and retrospective clinical studies involving adult patients with oropharyngeal cancer, (2) reports swallowing outcomes, (3) English studies or studies with English translation, (4) full text retrievable and (5) publication between 1990 and 2016. 410 unique studies were identified, and 106 were analyzed. A majority (> 80%) of studies that reported swallowing outcomes were published after 2010. While 75.4% of studies reported subjective outcomes (e.g., patient-reported or clinician-reported outcome measures), only 30.2% of studies presented results of objective instrumental assessment of swallowing. The majority (61%) of studies reported short-term swallowing outcomes at 1 year or less, and only 10% of studies examined 5-year swallowing comes. One study examined late-dysphagia (> 10 years) in the oropharyngeal cancer population. Considerable heterogeneity remains in the reporting of swallowing outcomes after treatment of oropharyngeal cancer despite its importance for quality of life. Studies reporting long-term swallowing outcomes are lacking in the literature, and objective measures of swallowing function remain underutilized and nonstandardized.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Chaturvedi AK, Anderson WF, Lortet-Tieulent J, et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. J Clin Oncol. 2013;31(36):4550–9.

    Article  Google Scholar 

  2. Chaturvedi AK, Engels EA, Pfeiffer RM, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol. 2011;29(32):4294–301.

    Article  Google Scholar 

  3. Goldsmith TA, Roe JW. Human papilloma virus-related oropharyngeal cancer: opportunities and challenges in dysphagia management. Curr Opin Otolaryngol Head Neck Surg. 2015;23:185–90.

    Article  Google Scholar 

  4. Wall LR, Ward EC, Cartmill B, Hill AJ. Physiological changes to the swallowing mechanism following (chemo)radiotherapy for head and neck cancer: a systematic review. Dysphagia. 2013;28:481–93.

    Article  Google Scholar 

  5. Clarke P, Radford K, Coffey M, Stewart M. Speech and swallow rehabilitation in head and neck cancer: United kingdom national multidisciplinary guidelines. J Laryngol Otol. 2016;130:S176–80.

    Article  CAS  Google Scholar 

  6. Denaro N, Merlano MC, Russi EG. Dysphagia in head and neck cancer patients: pretreatment evaluation, predictive factors, and assessment during radio-chemotherapy recommendations. Clin Exp Otorhinolaryngol. 2013;6(3):117–26.

    Article  Google Scholar 

  7. Dwivedi RC, Chisholm EJ, Khan AS, et al. An exploratory study of the influence of clinico-demographic variables on swallowing and swallowing-related quality of life in a cohort of oral and oropharyngeal cancer patients treated with primary surgery. Eur Arch Otorhinolaryngol. 2012;269(4):1233–9.

    Article  Google Scholar 

  8. Krekeler BN, Broadfoot CK, Johnson S, et al. Patient adherence to dysphagia recommendations: a systematic review. Dysphagia. 2018;33(2):173–84.

    Article  Google Scholar 

  9. Jaffer NM, Ng E, Au FW, Steele CM. Fluoroscopic evaluation of oropharyngeal dysphagia: anatomic, technical, and common etiologic factors. Am J Roentgenol. 2015;204(1):49–58.

    Article  Google Scholar 

  10. Jensen K, Lambertsen K, Torkov P, et al. Patient assessed symptoms are poor predictors of objective findings Results from a cross sectional study in patients treated with radiotherapy for pharyngeal cancer. Acta Oncol. 2007;46(8):1159–68.

    Article  Google Scholar 

  11. Kendall KA, Tanner K, Kosek SR. Quality-of-life scores compared to objective measures of swallowing after oropharyngeal chemoradiation. Laryngoscope. 2014;124(3):682–7.

    Article  Google Scholar 

  12. Lazarus CL. Effects of chemoradiotherapy on voice and swallowing. Curr Opin Otolaryngol Head Neck Surg. 2009;17(3):172–8.

    Article  Google Scholar 

  13. Liberati A, Altman DG, Tetzlaff J, et al. Methods of systematic reviews and meta-analysis: the PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1–34.

    Article  Google Scholar 

  14. Booth A. How much searching is enough? Comprehensive versus optimal retrieval for technology assessments. Int J Technol Assess Health Care. 2012;26:431–5.

    Article  Google Scholar 

  15. Burnham JF. Scopus database: a review. Biomed Digit Libr. 2006;3:1. https://doi.org/10.1186/1742-5581-3-1.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Phillips Bob, Ball Chris, Sackett Dave, et al. Oxford Centre for evidence-based medicine–levels of evidence. CEBM: University of Oxford; 2009.

    Google Scholar 

  17. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31(5):1341–6.

    Article  CAS  Google Scholar 

  18. Hassan SJ, Weymuller EA. Assessment of quality of life in head and neck cancer patients. Head Neck. 1993;15(6):485–96.

    Article  CAS  Google Scholar 

  19. Chen AY, Frankowski R, Bishop-Leone 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(7):870–6.

    CAS  PubMed  Google Scholar 

  20. Hutcheson KA, Yuk MM, Holsinger FC, et al. Late radiation-associated dysphagia with lower cranial neuropathy in long-term oropharyngeal cancer survivors: video case reports. Head Neck. 2015;37(4):E56–62.

    Article  Google Scholar 

  21. Eisbruch A, Kim HM, Feng FY, et al. Chemo-IMRT of oropharyngeal cancer aiming to reduce dysphagia: swallowing organs late complication probabilities and dosimetric correlates. Int J Radiat Oncol Biol Phys. 2011;81(3):e93–9. https://doi.org/10.1016/j.ijrobp.2010.12.067Epub 2011 May 17.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hutcheson KA, Lewin JS, Barringer DA, et al. Late dysphagia after radiotherapy-based treatment of head and neck cancer. Cancer. 2012;118(23):5793–9. .

    Article  Google Scholar 

  23. Nguyen NP, Frank C, Moltz CC, et al. Analysis of factors influencing aspiration risk following chemoradiation for oropharyngeal cancer. Br J Radiol. 2009;82(980):675–80.

    Article  CAS  Google Scholar 

  24. Eisbruch A, Kim HM, Feng FY, et al. Chemo-IMRT of oropharyngeal cancer aiming to reduce dysphagia: swallowing organs late complication probabilities and dosimetric correlates. Int J Radiat Oncol Biol Phys. 2011;81(3):e93–9.

    Article  Google Scholar 

  25. Nguyen NP, Frank C, Moltz CC, et al. Dysphagia severity and aspiration following postoperative radiation for locally advanced oropharyngeal cancer. Anticancer Res. 2008;28(1B):431–4.

    PubMed  Google Scholar 

  26. Hutcheson KA, Yuk M, Hubbard R, et al. Delayed lower cranial neuropathy after oropharyngeal intensity-modulated radiotherapy: a cohort analysis and literature review. Head Neck. 2017;39(8):1516–23.

    Article  Google Scholar 

  27. Wilson JA, Carding PN, Patterson JM. Dysphagia after nonsurgical head and neck cancer treatment: patients’ perspectives. Otolaryngol Head Neck Surg. 2011;145(5):767–71.

    Article  Google Scholar 

  28. Simon C, Caballero C, Gregoire V, et al. Surgical quality assurance in head and neck cancer trials: an EORTC Head and Neck Cancer Group position paper based on the EORTC 1420 ‘Best of’ and 24954 ‘larynx preservation’ study. Eur J Cancer. 2018;103:69–77.

    Article  Google Scholar 

  29. Simon C, Caballero C. Quality assurance and improvement in head and neck cancer surgery: from clinical trials to National Healthcare Initiatives. Curr Treat Options Oncol. 2018;19(7):34.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Caroline C. Jeffery.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, P., Constantinescu, G.C., Nguyen, NT.A. et al. Trends in Reporting of Swallowing Outcomes in Oropharyngeal Cancer Studies: A Systematic Review. Dysphagia 35, 18–23 (2020). https://doi.org/10.1007/s00455-019-09996-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-019-09996-7

Keywords

Navigation