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Dysphagia Secondary to the Effects of Chemotherapy and Radiotherapy

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Principles of Deglutition

Abstract

This chapter reviews the effects of chemotherapy and radiotherapy on swallowing in treated head and neck cancer patients. Early and late effects of radiotherapy on tissues are described. Specific effects of chemotherapy and radiotherapy on oropharyngeal swallowing are reviewed. Behavioral, medical, and surgical management of dysphagia in this population are discussed.

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References

  1. Francis DO, et al. Dysphagia, stricture, and pneumonia in head and neck cancer patients: does treatment modality matter? Ann Otol Rhinol Laryngol. 2010;119(6):391–7.

    PubMed  Google Scholar 

  2. Hughes PJ, et al. Dysphagia in treated nasopharyngeal cancer. Head Neck. 2000;22(4):393–7.

    Article  PubMed  CAS  Google Scholar 

  3. Carrara-de Angelis E. Voice and swallowing in patients enrolled in a larynx preservation trial. Arch Otolaryngol Head Neck Surg. 2003;129(7):733–8.

    Article  PubMed  Google Scholar 

  4. Lazarus CL, et al. Swallowing disorders in head and neck cancer patients treated with radiotherapy and adjuvant chemotherapy. Laryngoscope. 1996;106(9 Pt 1):1157–66.

    Article  PubMed  CAS  Google Scholar 

  5. Lazarus CL, et al. Swallowing and tongue function following treatment for oral and oropharyngeal cancer. J Speech Lang Hear Res. 2000;43(4):1011–23.

    PubMed  CAS  Google Scholar 

  6. Kotz T, et al. Pharyngeal transport dysfunction consequent to an organ-sparing protocol. Arch Otolaryngol Head Neck Surg. 1999;125(4):410–3.

    PubMed  CAS  Google Scholar 

  7. Mendenhall WM, et al. Is radiation therapy a preferred alternative to surgery for squamous cell carcinoma of the base of tongue? J Clin Oncol. 2000;18(1):35–42.

    PubMed  CAS  Google Scholar 

  8. Sessions DG, et al. Analysis of treatment results for base of tongue cancer. Laryngoscope. 2003;113(7):1252–61.

    Article  PubMed  Google Scholar 

  9. Vokes EE, et al. Induction chemotherapy followed by concomitant chemoradiotherapy for advanced head and neck cancer: impact on the natural history of the disease. J Clin Oncol. 1995;13(4):876–83.

    PubMed  CAS  Google Scholar 

  10. Lefebvre JL, et al. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst. 1996;88(13):890–9.

    Article  PubMed  CAS  Google Scholar 

  11. The Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med. 1991;324(24):1685–90.

    Article  Google Scholar 

  12. Harrison LB, et al. Performance status after treatment for squamous cell cancer of the base of tongue–a comparison of primary radiation therapy versus primary surgery. Int J Radiat Oncol Biol Phys. 1994;30(4):953–7.

    Article  PubMed  CAS  Google Scholar 

  13. Forastiere AA, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med. 2003;349(22):2091–8.

    Article  PubMed  CAS  Google Scholar 

  14. Calais G, et al. Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma. J Natl Cancer Inst. 1999;91(24):2081–6.

    Article  PubMed  CAS  Google Scholar 

  15. Adelstein DJ, et al. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol. 2003;21(1):92–8.

    Article  PubMed  Google Scholar 

  16. Budach W, et al. A meta-analysis of hyperfractionated and accelerated radiotherapy and combined chemotherapy and radiotherapy regimens in unresected locally advanced squamous cell carcinoma of the head and neck. BMC Cancer. 2006;6:28.

    Article  PubMed  CAS  Google Scholar 

  17. Mendenhall WM, et al. Altered fractionation and/or adjuvant chemotherapy in definitive irradiation of squamous cell carcinoma of the head and neck. Laryngoscope. 2003;113(3):546–51.

    Article  PubMed  Google Scholar 

  18. Gorodetsky R, Amir G, Yarom R. Effect of ionizing radiation on neuromuscular junctions in mouse tongues. Int J Radiat Biol. 1992;61(4):539–44.

    Article  PubMed  CAS  Google Scholar 

  19. Love S, Gomez S. Effects of experimental radiation-induced hypomyelinating neuropathy on motor end-plates and neuromuscular transmission. J Neurol Sci. 1984;65(1):93–109.

    Article  PubMed  CAS  Google Scholar 

  20. Khan MY. Radiation-induced changes in skeletal muscle. An electron microscopic study. J Neuro­pathol Exp Neurol. 1974;33(1):42–57.

    Article  PubMed  CAS  Google Scholar 

  21. Remy J, et al. Long-term overproduction of collagen in radiation-induced fibrosis. Radiat Res. 1991;125(1):14–9.

    Article  PubMed  CAS  Google Scholar 

  22. Treister N, Sonis S. Mucositis: biology and management. Curr Opin Otolaryngol Head Neck Surg. 2007;15(2):123–9.

    Article  PubMed  Google Scholar 

  23. Arcuri MR, Schneider RL. The physiological effects of radiotherapy on oral tissue. J Prosthodont. 1992;1(1):37–41.

    Article  PubMed  CAS  Google Scholar 

  24. Knowles JC, Chalian VA, Shidnia H. Pulp innervation after radiation therapy. J Prosthet Dent. 1986;56(6):708–11.

    Article  PubMed  CAS  Google Scholar 

  25. Aviv JE, et al. Surface sensibility of the floor of the mouth and tongue in healthy controls and in radiated patients. Otolaryngol Head Neck Surg. 1992;107(3):418–23.

    PubMed  CAS  Google Scholar 

  26. Ichimura K, Tanaka T. Trismus in patients with malignant tumours in the head and neck. J Laryngol Otol. 1993;107(11):1017–20.

    Article  PubMed  CAS  Google Scholar 

  27. Schwartz LK, et al. Taste intensity performance in patients irradiated to the head and neck. Physiol Behav. 1993;53(4):671–7.

    Article  PubMed  CAS  Google Scholar 

  28. Abu Shara KA, et al. Radiotherapeutic effect on oropharyngeal flora in patients with head and neck cancer. J Laryngol Otol. 1993;107(3):222–7.

    Article  PubMed  CAS  Google Scholar 

  29. Nguyen NP, et al. Effectiveness of the cough reflex in patients with aspiration following radiation for head and neck cancer. Lung. 2007;185(5):243–8.

    Article  PubMed  Google Scholar 

  30. Machtay M, et al. Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol. 2008;26(21):3582–9.

    Article  PubMed  CAS  Google Scholar 

  31. Gillette EL, et al. Late radiation injury to muscle and peripheral nerves. Int J Radiat Oncol Biol Phys. 1995;31(5):1309–18.

    Article  PubMed  CAS  Google Scholar 

  32. Johansson S, Svensson H, Denekamp J. Dose response and latency for radiation-induced fibrosis, edema, and neuropathy in breast cancer patients. Int J Radiat Oncol Biol Phys. 2002;52(5):1207–19.

    Article  PubMed  Google Scholar 

  33. Lin YS, Jen YM, Lin JC. Radiation-related cranial nerve palsy in patients with nasopharyngeal carcinoma. Cancer. 2002;95(2):404–9.

    Article  PubMed  Google Scholar 

  34. Denham JW, Hauer-Jensen M. The radiotherapeutic injury–a complex “wound”. Radiother Oncol. 2002;63(2):129–45.

    Article  PubMed  Google Scholar 

  35. Burger A, et al. Molecular and cellular basis of radiation fibrosis. Int J Radiat Biol. 1998;73(4):401–8.

    Article  PubMed  CAS  Google Scholar 

  36. Ben-Yosef R, Kapp DS. Persistent and/or late complications of combined radiation therapy and hyperthermia. Int J Hyperthermia. 1992;8(6):733–45.

    Article  PubMed  CAS  Google Scholar 

  37. Bentzen SM, Thames HD, Overgaard M. Latent-time estimation for late cutaneous and subcutaneous radiation reactions in a single-follow-up clinical study. Radiother Oncol. 1989;15(3):267–74.

    Article  PubMed  CAS  Google Scholar 

  38. Brown AP, Fixsen JA, Plowman PN. Local control of Ewing’s sarcoma: an analysis of 67 patients. Br J Radiol. 1987;60(711):261–8.

    Article  PubMed  CAS  Google Scholar 

  39. Huang YP, Zheng YP, Leung SF. Quasi-linear viscoelastic properties of fibrotic neck tissues obtained from ultrasound indentation tests in vivo. Clin Biomech. 2005;20(2):145–54.

    Article  Google Scholar 

  40. Lazarus CL, et al. Swallow recovery in an oral cancer patient following surgery, radiotherapy, and hyperthermia. Head Neck. 1994;16(3):259–65.

    Article  PubMed  CAS  Google Scholar 

  41. Karasek K, Constine LS, Rosier R. Sarcoma therapy: functional outcome and relationship to treatment parameters. Int J Radiat Oncol Biol Phys. 1992;24(4):651–6.

    Article  PubMed  CAS  Google Scholar 

  42. Maciejewski B, et al. Dose fractionation and regeneration in radiotherapy for cancer of the oral cavity and oropharynx. Part 2. Normal tissue responses: acute and late effects. Int J Radiat Oncol Biol Phys. 1990;18(1):101–11.

    Article  PubMed  CAS  Google Scholar 

  43. Bentzen SM, Turesson I, Thames HD. Fractionation sensitivity and latency of telangiectasia after postmastectomy radiotherapy: a graded-response analysis. Radiother Oncol. 1990;18(2):95–106.

    Article  PubMed  CAS  Google Scholar 

  44. Salama JK, et al. Induction chemotherapy and concurrent chemoradiotherapy for locoregionally advanced head and neck cancer: a multi-institutional phase II trial investigating three radiotherapy dose levels. Ann Oncol. 2008;19(10):1787–94.

    Article  PubMed  CAS  Google Scholar 

  45. Jentzsch K, et al. Leg function after radiotherapy for Ewing’s sarcoma. Cancer. 1981;47(6):1267–78.

    Article  PubMed  CAS  Google Scholar 

  46. Stinson SF, et al. Acute and long-term effects on limb function of combined modality limb sparing therapy for extremity soft tissue sarcoma. Int J Radiat Oncol Biol Phys. 1991;21(6):1493–9.

    Article  PubMed  CAS  Google Scholar 

  47. Fox PC, et al. Xerostomia: evaluation of a symptom with increasing significance. J Am Dent Assoc. 1985;110(4):519–25.

    PubMed  CAS  Google Scholar 

  48. Abd-El-Malek S. Observations on the morphology of the human tongue. J Anat. 1939;73(Pt 2):201–10. 3.

    PubMed  CAS  Google Scholar 

  49. Sonies BC, Ship JA, Baum BJ. Relationship between saliva production and oropharyngeal swallow in healthy, different-aged adults. Dysphagia. 1989;4(2):85–9.

    Article  PubMed  CAS  Google Scholar 

  50. Mansson I, Sandberg N. Oro-pharyngeal sensitivity and elicitation of swallowing in man. Acta Otolaryngol. 1975;79(1–2):140–5.

    Article  PubMed  CAS  Google Scholar 

  51. De Fede O, et al. Oral manifestations in patients with gastro-oesophageal reflux disease: a single center case-control study. J Oral Pathol Med. 2008;37:336–40.

    Article  PubMed  Google Scholar 

  52. Kuo WR, et al. The effects of radiation therapy on salivary function in patients with head and neck cancer. Gaoxiong Yi Xue Ke Xue Za Zhi. 1993;9(7):401–9.

    PubMed  CAS  Google Scholar 

  53. Logemann JA, et al. Effects of xerostomia on perception and performance of swallow function. Head Neck. 2001;23(4):317–21.

    Article  PubMed  CAS  Google Scholar 

  54. Hammerlid E, et al. A prospective quality of life study of patients with laryngeal carcinoma by tumor stage and different radiation therapy schedules. Laryngoscope. 1998;108(5):747–59.

    Article  PubMed  CAS  Google Scholar 

  55. de Graeff A, et al. A prospective study on quality of life of laryngeal cancer patients treated with radiotherapy. Head Neck. 1999;21(4):291–6.

    Article  PubMed  Google Scholar 

  56. List MA, et al. Quality of life and performance in advanced head and neck cancer patients on concomitant chemoradiotherapy: a prospective examination. J Clin Oncol. 1999;17(3):1020–8.

    PubMed  CAS  Google Scholar 

  57. Oates JE, et al. Prospective evaluation of quality of life and nutrition before and after treatment for nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2007;133(6):533–40.

    Article  PubMed  Google Scholar 

  58. Boscolo-Rizzo P, et al. Long-term quality of life after total laryngectomy and postoperative radiotherapy versus concurrent chemoradiotherapy for laryngeal preservation. Laryngoscope. 2008;118(2):300–6.

    Article  PubMed  Google Scholar 

  59. Newman LA, et al. Eating and weight changes following chemoradiation therapy for advanced head and neck cancer. Arch Otolaryngol Head Neck Surg. 1998;124(5):589–92.

    PubMed  CAS  Google Scholar 

  60. Garcia-Peris P, et al. Long-term prevalence of oropharyngeal dysphagia in head and neck cancer patients: impact on quality of life. Clin Nutr. 2007;26(6):710–7.

    Article  PubMed  CAS  Google Scholar 

  61. Lazarus C, et al. Effects of radiotherapy with or without chemotherapy on tongue strength and swallowing in patients with oral cancer. Head Neck. 2007;29(7):632–7.

    Article  PubMed  Google Scholar 

  62. Capuano G, et al. Influence of weight loss on outcomes in patients with head and neck cancer undergoing concomitant chemoradiotherapy. Head Neck. 2008;30(4):503–8.

    Article  PubMed  Google Scholar 

  63. Morton RP, et al. Elective gastrostomy, nutritional status and quality of life in advanced head and neck cancer patients receiving chemoradiotherapy. ANZ J Surg. 2009;79(10):713–8.

    Article  PubMed  Google Scholar 

  64. Chang JH, et al. Prophylactic gastrostomy tubes for patients receiving radical radiotherapy for head and neck cancers: a retrospective review. J Med Imaging Radiat Oncol. 2009;53(5):494–9.

    Article  PubMed  CAS  Google Scholar 

  65. McLaughlin BT, et al. Management of patients treated with chemoradiotherapy for head and neck cancer without prophylactic feeding tubes: the University of Pittsburgh experience. Laryngoscope. 2010;120(1):71–5.

    PubMed  Google Scholar 

  66. Lee H, et al. Effect of oral nutritional supplementation on weight loss and percutaneous endoscopic gastrostomy tube rates in patients treated with radiotherapy for oropharyngeal carcinoma. Support Care Cancer. 2008;16(3):285–9.

    Article  PubMed  Google Scholar 

  67. Clavel S, et al. Enteral feeding during chemoradiotherapy for advanced head-and-neck cancer: a single-institution experience using a reactive approach. Int J Radiat Oncol Biol Phys. 2011;79(3):763–9.

    Article  PubMed  Google Scholar 

  68. Dworkin JP, et al. Swallowing function outcomes following nonsurgical therapy for advanced-stage laryngeal carcinoma. Dysphagia. 2006;21(1):66–74.

    Article  PubMed  Google Scholar 

  69. Smith RV, et al. Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea: initial results. Arch Otolaryngol Head Neck Surg. 2000;126(3):384–9.

    PubMed  CAS  Google Scholar 

  70. Kendall KA, et al. Structural mobility in deglutition after single modality treatment of head and neck carcinomas with radiotherapy. Head Neck. 1998;20(8):720–5.

    Article  PubMed  CAS  Google Scholar 

  71. Murry T, et al. Acute and chronic changes in swallowing and quality of life following intraarterial chemoradiation for organ preservation in patients with advanced head and neck cancer. Head Neck. 1998;20(1):31–7.

    Article  PubMed  CAS  Google Scholar 

  72. Hutcheson KA, et al. Swallowing outcomes after radiotherapy for laryngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2008;134(2):178–83.

    Article  PubMed  Google Scholar 

  73. Logemann JA, et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008;30(2):148–58.

    Article  PubMed  Google Scholar 

  74. Rademaker AW, et al. Oropharyngeal swallow efficiency as a representative measure of swallowing function. J Speech Hear Res. 1994;37(2):314–25.

    PubMed  CAS  Google Scholar 

  75. Pauloski BR, et al. Relationship between manometric and videofluoroscopic measures of swallow function in healthy adults and patients treated for head and neck cancer with various modalities. Dysphagia. 2009;24(2):196–203.

    Article  PubMed  Google Scholar 

  76. Vu KN, et al. Proximal esophageal stenosis in head and neck cancer patients after total laryngectomy and radiation. ORL J Otorhinolaryngol Relat Spec. 2008;70(4):229–35.

    Article  PubMed  Google Scholar 

  77. Watkin KL, et al. Ultrasonic quantification of geniohyoid cross-sectional area and tissue composition: a preliminary study of age and radiation effects. Head Neck. 2001;23(6):467–74.

    Article  PubMed  CAS  Google Scholar 

  78. Eisele DW, et al. Case report: aspiration from delayed radiation fibrosis of the neck. Dysphagia. 1991;6(2):120–2.

    Article  PubMed  CAS  Google Scholar 

  79. Pauloski BR, Logemann JA. Impact of tongue base and posterior pharyngeal wall biomechanics on pharyngeal clearance in irradiated postsurgical oral and oropharyngeal cancer patients. Head Neck. 2000;22(2):120–31.

    Article  PubMed  CAS  Google Scholar 

  80. Lazarus CL. Effects of radiation therapy and voluntary maneuvers on swallow functioning in head and neck cancer patients. Clin Commun Disord. 1993;3(4):11–20.

    PubMed  CAS  Google Scholar 

  81. Schuller DE, et al. Multimodal intensification regimens for advanced, resectable, previously untreated squamous cell cancer of the oral cavity, oropharynx, or hypopharynx: a 12-year experience. Arch Otolaryngol Head Neck Surg. 2007;133(4):320–6.

    Article  PubMed  Google Scholar 

  82. Malone JP, et al. Disease control, survival, and functional outcome after multimodal treatment for advanced-stage tongue base cancer. Head Neck. 2004;26(7):561–72.

    Article  PubMed  Google Scholar 

  83. Grecula JC, et al. Long-term follow-up on an intensified treatment regimen for advanced resectable head and neck squamous cell carcinomas. Cancer Invest. 2001;19(2):127–36.

    Article  PubMed  CAS  Google Scholar 

  84. Garrett P, et al. Intraoperative radiation therapy for advanced or recurrent head and neck cancer. Int J Radiat Oncol Biol Phys. 1987;13(5):785–8.

    Article  PubMed  CAS  Google Scholar 

  85. Ship JA, Hu K. Radiotherapy-induced salivary dysfunction. Semin Oncol. 2004;31(6 Suppl 18):29–36.

    Article  PubMed  Google Scholar 

  86. Kumar B, et al. EGFR, p16, HPV Titer, Bcl-xL and p53, sex, and smoking as indicators of response to therapy and survival in oropharyngeal cancer. J Clin Oncol. 2008;26(19):3128–37.

    Article  PubMed  Google Scholar 

  87. Gillison ML, et al. Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst. 2000;92(9):709–20.

    Article  PubMed  CAS  Google Scholar 

  88. D’Souza G, et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 2007;356(19):1944–56.

    Article  PubMed  Google Scholar 

  89. Ang KK, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010;363(1):24–35.

    Article  PubMed  CAS  Google Scholar 

  90. Logemann JA. Approaches to management of disordered swallowing. Baillieres Clin Gastroenterol. 1991;5(2):269–80.

    Article  PubMed  CAS  Google Scholar 

  91. Martin-Harris B, et al. MBS measurement tool for swallow impairment–MBSImp: establishing a standard. Dysphagia. 2008;23(4):392–405.

    Article  PubMed  Google Scholar 

  92. Aviv JE, et al. Fiberoptic endoscopic evaluation of swallowing with sensory testing (FEESST) in healthy controls. Dysphagia. 1998;13(2):87–92.

    Article  PubMed  CAS  Google Scholar 

  93. Langmore SE, Schatz K, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia. 1988;2(4):216–9.

    Article  PubMed  CAS  Google Scholar 

  94. Leder SB. Serial fiberoptic endoscopic swallowing evaluations in the management of patients with dysphagia. Arch Phys Med Rehabil. 1998;79(10):1264–9.

    Article  PubMed  CAS  Google Scholar 

  95. Lazarus CL. Management of swallowing disorders in head and neck cancer patients: optimal patterns of care. Semin Speech Lang. 2000;21(4):293–309.

    Article  PubMed  CAS  Google Scholar 

  96. Logemann JA. Rehabilitation of oropharyngeal swallowing disorders. Acta Otorhinolaryngol Belg. 1994;48(2):207–15.

    PubMed  CAS  Google Scholar 

  97. McConnel FM, Mendelsohn MS, Logemann JA. Manofluorography of deglutition after supraglottic laryngectomy. Head Neck Surg. 1987;9(3):142–50.

    Article  PubMed  CAS  Google Scholar 

  98. McConnel FM, et al. Manofluorography of deglutition after total laryngopharyngectomy. Plast Reconstr Surg. 1988;81(3):346–51.

    Article  PubMed  CAS  Google Scholar 

  99. Lazarus C, et al. Effects of voluntary maneuvers on tongue base function for swallowing. Folia Phoniatr Logop. 2002;54(4):171–6.

    Article  PubMed  Google Scholar 

  100. Kahrilas PJ, et al. Volitional augmentation of upper esophageal sphincter opening during swallowing. Am J Physiol. 1991;260(3 Pt 1):G450–6.

    PubMed  CAS  Google Scholar 

  101. Shaker R, et al. Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise. Am J Physiol. 1997;272(6 Pt 1):G1518–22.

    PubMed  CAS  Google Scholar 

  102. Logemann JA, et al. A randomized study comparing the Shaker exercise with traditional therapy: a preliminary study. Dysphagia. 2009;24(4):403–11.

    Article  PubMed  Google Scholar 

  103. Easterling C. Does an exercise aimed at improving swallow function have an effect on vocal function in the healthy elderly? Dysphagia. 2008;23(3):317–26.

    Article  PubMed  Google Scholar 

  104. Martin BJ, et al. Normal laryngeal valving patterns during three breath-hold maneuvers: a pilot investigation. Dysphagia. 1993;8(1):11–20.

    Article  PubMed  CAS  Google Scholar 

  105. Logemann JA, et al. Closure mechanisms of laryngeal vestibule during swallow. Am J Physiol. 1992;262(2 Pt 1):G338–44.

    PubMed  CAS  Google Scholar 

  106. Steele CM, Huckabee ML. The influence of orolingual pressure on the timing of pharyngeal pressure events. Dysphagia. 2007;22(1):30–6.

    Article  PubMed  Google Scholar 

  107. Hind JA, et al. Comparison of effortful and noneffortful swallows in healthy middle-aged and older adults. Arch Phys Med Rehabil. 2001;82(12):1661–5.

    Article  PubMed  CAS  Google Scholar 

  108. Takasaki K, et al. Influence of effortful swallow on pharyngeal pressure: evaluation using a high-resolution manometry. Otolaryngol Head Neck Surg. 2011;144(1):16–20.

    Article  PubMed  Google Scholar 

  109. Huckabee ML, et al. Submental surface electromyographic measurement and pharyngeal pressures during normal and effortful swallowing. Arch Phys Med Rehabil. 2005;86(11):2144–9.

    Article  PubMed  Google Scholar 

  110. Huckabee ML, Steele CM. An analysis of lingual contribution to submental surface electromyographic measures and pharyngeal pressure during effortful swallow. Arch Phys Med Rehabil. 2006;87(8):1067–72.

    Article  PubMed  Google Scholar 

  111. Fujiu M, Logemann J, Pauloski B. Increased postoperative posterior pharyngeal wall movement in patients with anterior oral cancer: preliminary findings and possible implications for treatment. Am J Speech Lang Pathol. 1995;4:24–30.

    Google Scholar 

  112. Fujiu M, Logemann J. Effect of a tongue-holding maneuver on posterior pharyngeal wall movement during deglutition. Am J Speech Lang Pathol. 1996;5:23–30.

    Google Scholar 

  113. Fuller SC, et al. Validation of the pharyngeal squeeze maneuver. Otolaryngol Head Neck Surg. 2009;140(3):391–4.

    Article  PubMed  Google Scholar 

  114. Eisbruch A, et al. Can IMRT or brachytherapy reduce dysphagia associated with chemoradiotherapy of head and neck cancer? The Michigan and Rotterdam experiences. Int J Radiat Oncol Biol Phys. 2007;69(2 Suppl):S40–2.

    Article  PubMed  Google Scholar 

  115. Veis S, Logemann JA, Colangelo L. Effects of three techniques on maximum posterior movement of the tongue base. Dysphagia. 2000;15(3):142–5.

    PubMed  CAS  Google Scholar 

  116. Logemann JA. Rehabilitation of head and neck cancer patients. Cancer Treat Res. 1999;100:91–105.

    Article  PubMed  CAS  Google Scholar 

  117. Lazarus C, et al. Effects of two types of tongue strengthening exercises in young normals. Folia Phoniatr Logop. 2003;55(4):199–205.

    Article  PubMed  Google Scholar 

  118. Robbins J, et al. The effects of lingual exercise on swallowing in older adults. J Am Geriatr Soc. 2005;53(9):1483–9.

    Article  PubMed  Google Scholar 

  119. Robbin J, et al. The effects of lingual exercise in stroke patients with dysphagia. Arch Phys Med Rehabil. 2007;88(2):150–8.

    Article  Google Scholar 

  120. Carroll WR, et al. Pretreatment swallowing exercises improve swallow function after chemoradiation. Laryngoscope. 2008;118(1):39–43.

    Article  PubMed  Google Scholar 

  121. Kulbersh BD, et al. Pretreatment, preoperative swallowing exercises may improve dysphagia quality of life. Laryngoscope. 2006;116(6):883–6.

    Article  PubMed  Google Scholar 

  122. Chang CW, et al. Early radiation effects on tongue function for patients with nasopharyngeal carcinoma: a preliminary study. Dysphagia. 2008;23(2):193–8.

    Article  PubMed  Google Scholar 

  123. Buchbinder D, et al. Mobilization regimens for the prevention of jaw hypomobility in the radiated patient: a comparison of three techniques. J Oral Maxillofac Surg. 1993;51(8):863–7.

    Article  PubMed  CAS  Google Scholar 

  124. van der Molen L, et al. A randomized preventive rehabilitation trial in advanced head and neck cancer patients treated with chemoradiotherapy: feasibility, compliance, and short-term effects. Dysphagia. 2011;26(2):155–70.

    Article  PubMed  Google Scholar 

  125. Waters TM, et al. Beyond efficacy and effectiveness: conducting economic analyses during clinical trials. Dysphagia. 2004;19(2):109–19.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  127. Ludlow CL. Electrical neuromuscular stimulation in dysphagia: current status. Curr Opin Otolaryngol Head Neck Surg. 2010;18(3):159–64.

    Article  PubMed  Google Scholar 

  128. Lennox AJ, et al. Pilot study of impedance-controlled microcurrent therapy for managing radiation-induced fibrosis in head-and-neck cancer patients. Int J Radiat Oncol Biol Phys. 2002;54(1):23–34.

    Article  PubMed  Google Scholar 

  129. Pitts T, et al. Impact of expiratory muscle strength training on voluntary cough and swallow function in Parkinson disease. Chest. 2009;135(5):1301–8.

    Article  PubMed  Google Scholar 

  130. Sapienza CM, Wheeler K. Respiratory muscle strength training: functional outcomes versus plasticity. Semin Speech Lang. 2006;27(4):236–44.

    Article  PubMed  Google Scholar 

  131. Sapienza CM. Respiratory muscle strength training applications. Curr Opin Otolaryngol Head Neck Surg. 2008;16(3):216–20.

    Article  PubMed  Google Scholar 

  132. Saleem AF, Sapienza CM, Okun MS. Respiratory muscle strength training: treatment and response duration in a patient with early idiopathic Parkinson’s disease. NeuroRehabilitation. 2005;20(4):323–33.

    PubMed  Google Scholar 

  133. Rajendran R, Rani V, Shaikh S. Pentoxifylline therapy: a new adjunct in the treatment of oral submucous fibrosis. Indian J Dent Res. 2006;17(4):190–8.

    Article  PubMed  CAS  Google Scholar 

  134. Korpan M, Crevenna R, Fialka Moser V. Lymphedema: a therapeutic approach in the treatment and rehabilitation of cancer patients. Am J Phys Med Rehabil. 2011;90(5 Suppl 1):S69–75.

    Article  PubMed  Google Scholar 

  135. Eisbruch A, et al. Dysphagia and aspiration after chemoradiotherapy for head-and-neck cancer: which anatomic structures are affected and can they be spared by IMRT? Int J Radiat Oncol Biol Phys. 2004;60(5):1425–39.

    Article  PubMed  Google Scholar 

  136. Schwartz DL, et al. Candidate dosimetric predictors of long-term swallowing dysfunction after oropharyngeal intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2010;78(5):1356–65.

    Article  PubMed  Google Scholar 

  137. Feng FY, et al. Intensity-modulated radiotherapy of head and neck cancer aiming to reduce dysphagia: early dose-effect relationships for the swallowing structures. Int J Radiat Oncol Biol Phys. 2007;68(5):1289–98.

    Article  PubMed  Google Scholar 

  138. Bueno R, et al. Combined antegrade and retrograde dilation: a new endoscopic technique in the management of complex esophageal obstruction. Gastrointest Endosc. 2001;54(3):368–72.

    Article  PubMed  CAS  Google Scholar 

  139. Goguen LA, et al. Combined antegrade and retrograde esophageal dilation for head and neck cancer-related complete esophageal stenosis. Laryngoscope. 2010;120(2):261–6.

    PubMed  Google Scholar 

  140. Lew RJ, et al. Technique of endoscopic retrograde puncture and dilatation of total esophageal stenosis in patients with radiation-induced strictures. Head Neck. 2004;26(2):179–83.

    Article  PubMed  Google Scholar 

  141. Sullivan CA, et al. Endoscopic management of hypopharyngeal stenosis after organ sparing therapy for head and neck cancer. Laryngoscope. 2004;114(11):1924–31.

    Article  PubMed  Google Scholar 

  142. Amin AA, et al. Fasciocutaneous free flaps for hypopharyngeal reconstruction. J Reconstr Microsurg. 2002;18(1):1–5.

    Article  PubMed  Google Scholar 

  143. Lorenz RR, Alam DS. The increasing use of enteral flaps in reconstruction for the upper aerodigestive tract. Curr Opin Otolaryngol Head Neck Surg. 2003;11(4):230–5.

    Article  PubMed  Google Scholar 

  144. Delaere P, et al. Reconstruction for postcricoid pharyngeal stenosis after organ preservation protocols. Laryngoscope. 2006;116(3):502–4.

    Article  PubMed  Google Scholar 

  145. Urken ML, Jacobson AS, Lazarus CL. Comprehensive approach to restoration of function in patients with radiation-induced pharyngoesophageal stenosis: report of 31 patients and proposal of new classification scheme. Head and neck. 2011.

    Google Scholar 

  146. Johnstone PA, Niemtzow RC, Riffenburgh RH. Acupuncture for xerostomia: clinical update. Cancer. 2002;94(4):1151–6.

    Article  PubMed  Google Scholar 

  147. Garcia MK, et al. Acupuncture for radiation-induced xerostomia in patients with cancer: a pilot study. Head Neck. 2009;31(10):1360–8.

    Article  PubMed  Google Scholar 

  148. Blom M, Lundeberg T. Long-term follow-up of patients treated with acupuncture for xerostomia and the influence of additional treatment. Oral Dis. 2000;6(1):15–24.

    Article  PubMed  CAS  Google Scholar 

  149. O’Sullivan EM, Higginson IJ. Clinical effectiveness and safety of acupuncture in the treatment of irradiation-induced xerostomia in patients with head and neck cancer: a systematic review. Acupunct Med. 2010;28(4):191–9.

    Article  PubMed  Google Scholar 

  150. Teng MS, Futran ND. Osteoradionecrosis of the mandible. Curr Opin Otolaryngol Head Neck Surg. 2005;13(4):217–21.

    Article  PubMed  Google Scholar 

  151. Bras J, de Jonge HK, van Merkesteyn JP. Osteoradionecrosis of the mandible: pathogenesis. Am J Otolaryngol. 1990;11(4):244–50.

    Article  PubMed  CAS  Google Scholar 

  152. Marx RE. Osteoradionecrosis: a new concept of its pathophysiology. J Oral Maxillofac Surg. 1983;41(5):283–8.

    Article  PubMed  CAS  Google Scholar 

  153. Marx RE, Johnson RP. Studies in the radiobiology of osteoradionecrosis and their clinical significance. Oral Surg Oral Med Oral Pathol. 1987;64(4):379–90.

    Article  PubMed  CAS  Google Scholar 

  154. Annane D, et al. Hyperbaric oxygen therapy for radionecrosis of the jaw: a randomized, placebo-controlled, double-blind trial from the ORN96 study group. J Clin Oncol. 2004;22(24):4893–900.

    Article  PubMed  Google Scholar 

  155. Mounsey RA, et al. Role of hyperbaric oxygen therapy in the management of mandibular osteoradionecrosis. Laryngoscope. 1993;103(6):605–8.

    Article  PubMed  CAS  Google Scholar 

  156. Bak M, et al. Contemporary reconstruction of the mandible. Oral Oncol. 2010;46(2):71–6.

    Article  PubMed  Google Scholar 

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Correspondence to Cathy Lazarus PhD., CCC-SLP, BRS-S, ASHA Fellow .

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Lazarus, C. (2013). Dysphagia Secondary to the Effects of Chemotherapy and Radiotherapy. In: Shaker, R., Belafsky, P., Postma, G., Easterling, C. (eds) Principles of Deglutition. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3794-9_30

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