Weight loss and body mass index in relation to aspiration in patients treated for head and neck cancer: a long-term follow-up
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Persistent severe swallowing dysfunction with aspiration is a common and sometimes overlooked sequelae after treatment for squamous cell carcinoma of the head and neck (SCCHN) and may impact food intake and nutritional status. More knowledge is needed to increase the understanding of severe swallowing dysfunction as a risk factor for persistent nutritional deteriorations in SCCHN survivors. The purpose of the study was to investigate weight loss and body mass index (BMI) in relation to pharyngeal swallowing function in a long-term perspective in patients after SCCHN treatment.
Data from 101 patients were available for the analyses. Swallowing function was assessed by videofluoroscopy at a mean of 71.6 months after the start of radiotherapy (RT). Percent weight change (calculated with weight at the start of RT as the reference) and BMI at follow-up were the primary nutritional measures.
Aspiration was present in 48 of 101 patients (48 %). Patients with aspiration had a significantly higher mean weight loss and a lower BMI (−10.9 % and 23.1, respectively) at follow-up compared with patients without aspiration (−2.8 % and 26.0, respectively). Patients with aspiration were unable to gain weight after 23 months. Only ten of 101 patients (10 %) were underweight at follow-up.
Swallowing dysfunction with aspiration was related to long-term weight loss and reduced BMI. Few patients were underweight despite the high prevalence of swallowing dysfunction.
KeywordsFluoroscopy Swallowing dysfunction Head and neck cancer Weight loss Body mass index
This study was supported by grants from the Swedish Cancer Society, Laryngfonden (Sweden), Lions Cancer Research Foundation at Umeå University, and the Cancer Research Foundation of Northern Sweden. The study was made possible by the commitment from the staff at the participating centers in the ARTSCAN trial and the SALU study-Umeå University Hospital, Sunderby Hospital, Sundsvall Härnösand Hospital, Östersund Hospital, Lund University Hospital, and Malmö University Hospital. The authors acknowledge Ola Gärskog for help with the data collection and Ove Björ for statistical advice.
Conflict of interest statement
The authors have no conflict of interest to disclose and have full control of all primary data and agree to accept the journal to review the data if requested.
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