Nishant Agrawal

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Laryngeal penetration and aspiration during swallowing after the treatment of advanced oropharyngeal cancer.

M Boyd Gillespie; Martin B Brodsky; Terry A Day; Anand K Sharma; Fu-shing Lee; Bonnie Martin-Harris (Profiled Author: Martin Brodsky)

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston 29425, USA. gillesmb@musc.edu
Archives of otolaryngology--head & neck surgery 2005;131(7):615-9.

OBJECTIVE: To determine whether laryngeal penetration and aspiration in oropharyngeal cancer survivors differ by treatment group. DESIGN: Cross-sectional study of patients with stage III or IV oropharyngeal squamous cell carcinoma who were at least 12 months removed from combined modality therapy and clinically free of disease. SUBJECTS: Potential subjects were stratified by tumor site and tumor T stage to achieve a similar comparison between chemoradiotherapy (n = 10) and surgery/radiotherapy (n = 11) groups. Validated instruments used to evaluate swallowing included the Penetration-Aspiration Scale and the M. D. Anderson Dysphagia Inventory. RESULTS: Patients with oropharyngeal cancer treated with chemoradiotherapy demonstrated greater airway protection according to Penetration-Aspiration Scale scores than those treated with surgery and radiotherapy on 5-mL (P = .02), 10-mL (P = .04), and 20-mL (P = .04) liquid barium swallows. Also, the oropharyngeal chemoradiotherapy group had better self-perceived swallowing ability than the surgery-radiotherapy group on the basis of the M. D. Anderson Dysphagia Inventory (P = .02). CONCLUSION: The present study suggests that patients with oropharyngeal cancer who successfully complete chemoradiotherapy protocols without surgical salvage retain greater airway protection during swallowing and better swallowing-related quality of life than patients treated with primary surgery and radiotherapy.

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