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A Prospective Investigation of Swallowing, Nutrition, and Patient-rated Functional Impact Following Altered Fractionation Radiotherapy with Concomitant Boost for Oropharyngeal Cancer

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Abstract

Altered fractionation radiotherapy for head and neck cancer has been associated with improved locoregional control, overall survival, and heightened toxicity compared with conventional treatment. Swallowing, nutrition, and patient-perceived function for altered fractionation radiotherapy with concomitant boost (AFRT-CB) for T1–T3 oropharyngeal squamous cell carcinoma (SCC) have not been previously reported. Fourteen consecutive patients treated with AFRT-CB for oropharyngeal SCC were recruited from November 2006 to August 2009 in a tertiary hospital in Brisbane, Australia. Swallowing, nutrition, and patient-perceived functional impact assessments were conducted pretreatment, at 4–6 weeks post-treatment, and at 6 months post-treatment. Deterioration from pretreatment to 4–6 weeks post-treatment in swallowing, nutrition, and functional impact was evident, likely due to the heightened toxicity associated with AFRT-CB. There was significant improvement at 6 months post-treatment in functional swallowing, nutritional status, patient-perceived swallowing, and overall function, consistent with recovery from acute toxicity. However, weight and patient perception of physical function and side effects remained significantly worse than pretreatment scores. The ongoing deficits related to weight and patient-perceived outcomes at 6 months revealed that this treatment has a long-term impact on function possibly related to the chronic effects of AFRT-CB.

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Acknowledgment

Funding for this research was obtained as PhD scholarships through the Cancer Council Queensland and Cancer Collaborative Group (Princess Alexandra Hospital).

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Authors and Affiliations

  1. Speech Pathology Department, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, QLD, 4102, Australia

    Bena Cartmill

  2. School of Health and Rehabilitation Sciences, University of Queensland, Brisbane St Lucia, QLD, 4072, Australia

    Bena Cartmill, Elizabeth Ward & Sandro Porceddu

  3. Metro North Health Service District, Queensland Health, Herston, Australia

    Petrea Cornwell

  4. Griffith Health Institute, Griffith University, Mt Gravatt Campus, 176 Messines Ridge Road, Mt Gravatt, QLD, 4111, Australia

    Petrea Cornwell

  5. Centre for Functioning and Health Research, Queensland Health, Level 3, Buranda Shopping Centre, Ipswich Rd, Woolloongabba, QLD, 4102, Australia

    Elizabeth Ward

  6. Dietetics Department, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, QLD, 4102, Australia

    Wendy Davidson

  7. Radiation Oncology Department, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, QLD, 4102, Australia

    Sandro Porceddu

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Cartmill, B., Cornwell, P., Ward, E. et al. A Prospective Investigation of Swallowing, Nutrition, and Patient-rated Functional Impact Following Altered Fractionation Radiotherapy with Concomitant Boost for Oropharyngeal Cancer. Dysphagia 27, 32–45 (2012). https://doi.org/10.1007/s00455-011-9333-5

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