Dysphagia

, Volume 27, Issue 4, pp 481–490

Long-term Functional Outcomes and Patient Perspective Following Altered Fractionation Radiotherapy with Concomitant Boost for Oropharyngeal Cancer

  • Bena Cartmill
  • Petrea Cornwell
  • Elizabeth Ward
  • Wendy Davidson
  • Sandro Porceddu
Original Article

DOI: 10.1007/s00455-012-9394-0

Cite this article as:
Cartmill, B., Cornwell, P., Ward, E. et al. Dysphagia (2012) 27: 481. doi:10.1007/s00455-012-9394-0

Abstract

With no long-term data available in published research to date, this study presents details of the swallowing outcomes as well as barriers to and facilitators of oral intake and weight maintenance at 2 years after altered fractionation radiotherapy with concomitant boost (AFRT-CB). Twelve patients with T1–T3 oropharyngeal cancer who received AFRT-CB were assessed at baseline, 6 months, and 2 years post-treatment for levels of dysphagia and salivary toxicity, food and fluid tolerance, functional swallowing outcomes, patient-reported function, and weight. At 2 years, participants were also interviewed to explore barriers and facilitators of oral intake. Outcomes were significantly worse at 2 years when compared to baseline for late toxicity, functional swallowing, and patient-rated physical aspects of swallowing. Most patients (83%) tolerated a full diet pretreatment, but the rate fell to 42% (remainder tolerated soft diets) at 2 years. Multiple barriers to oral intake that impacted on activity and participation levels were identified. Participants lost 11 kg from baseline to 2 years, which was not regained between 6 months and 2 years. Global, social, and emotional domains of patient-reported function returned to pretreatment levels. At 2 years post AFRT-CB, worsening salivary and dysphagia toxicity, declining functional swallowing, and multiple reported ongoing barriers to oral intake had a negative impact on participants’ activity and participation levels relating to eating. These ongoing deficits contributed to significant deterioration in physical swallowing functioning determined by the MDADI. In contrast, patients perceived their broader functioning had improved at 2 years, suggesting long-term adjustment to ongoing swallowing deficits.

Keywords

Deglutition Deglutition disorders Long-term outcomes Altered fractionation radiotherapy Oropharynx Squamous cell carcinoma 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Bena Cartmill
    • 1
  • Petrea Cornwell
    • 2
  • Elizabeth Ward
    • 3
  • Wendy Davidson
    • 4
  • Sandro Porceddu
    • 5
  1. 1.Division of Speech Pathology and Speech Pathology DepartmentThe University of Queensland and Princess Alexandra HospitalBrisbaneAustralia
  2. 2.Griffith Health Institute and Metro North Health Service DistrictGriffith University and Queensland Health, Mt GravattBrisbaneAustralia
  3. 3.Division of Speech Pathology and Centre for Functioning and Health ResearchThe University of Queensland and Queensland HealthBrisbaneAustralia
  4. 4.Dietetics DepartmentPrincess Alexandra HospitalWoolloongabbaAustralia
  5. 5.Radiation Oncology Department and School of MedicinePrincess Alexandra Hospital and The University of QueenslandBrisbaneAustralia

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