Dysphagia

, Volume 29, Issue 3, pp 396–402

Effect of Gabapentin on Swallowing During and After Chemoradiation for Oropharyngeal Squamous Cell Cancer

  • Heather M. Starmer
  • WuYang Yang
  • Raju Raval
  • Christine G. Gourin
  • Marian Richardson
  • Rachit Kumar
  • Bronwyn Jones
  • Todd McNutt
  • Sierra Cheng
  • Harry Quon
Original Article

Abstract

The aim of this study was to examine the impact of gabapentin (neurontin) on swallowing and feeding tube use during chemoradiation (CRT) for oropharyngeal squamous cell carcinoma (OPSCC), and physiologic swallowing outcomes following completion of treatment. A total of 23 patients treated for OPSCC with concurrent CRT and prophylactically treated for pain using gabapentin were assessed. Historical controls were matched for T stage and primary site of disease. Timing of PEG use and removal were recorded. Video fluoroscopic swallowing studies were completed post-treatment to assess physiologic outcomes as well as penetration–aspiration scores (PAS). Functional oral intake scale (FOIS) scores were determined at the time of swallowing evaluation to assess diet level. Patients treated with gabapentin began using their PEG tubes later (3.7 vs. 2.29 weeks; P = 0.013) and had their PEG tubes removed earlier (7.29 vs. 32.56 weeks; P = 0.039) than the historical controls. A number of physiologic parameters were found to be less impacted in the gabapentin group, including oral bolus control (P = 0.01), epiglottic tilt (P = 0.0007), laryngeal elevation (P = 0.0017), and pharyngeal constriction (P = 0.002). PAS scores were significantly lower in the group treated with gabapentin (1.89 vs. 4; P = 0.0052). Patients receiving gabapentin had more advanced diet levels at the time of the initial swallowing study as evidenced by their FOIS scores (5.4 vs. 3.21; P = 0.0003). We conclude that patients using gabapentin for pain management during CRT appears to do well maintaining swallow function during treatment and have favorable post-treatment physiologic swallowing outcomes. Prospective evaluation is warranted.

Keywords

Dysphagia Head and neck cancer Gabapentin Swallowing Deglutition Deglutition disorders 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Heather M. Starmer
    • 1
  • WuYang Yang
    • 2
  • Raju Raval
    • 2
  • Christine G. Gourin
    • 1
  • Marian Richardson
    • 2
  • Rachit Kumar
    • 2
  • Bronwyn Jones
    • 3
  • Todd McNutt
    • 2
  • Sierra Cheng
    • 2
  • Harry Quon
    • 2
  1. 1.Johns Hopkins Outpatient Center, Department of Otolaryngology-Head and Neck SurgeryJohns Hopkins Medical InstitutionsBaltimoreUSA
  2. 2.Department of Radiation Oncology and Molecular Radiation SciencesJohns Hopkins Medical InstitutionsBaltimoreUSA
  3. 3.Department of RadiologyJohns Hopkins Medical InstitutionsBaltimoreUSA

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