Subjective Problems Swallowing in Head and Neck Cancer Survivors

Li-Jen Liao ； Pei-Yu Hou ； Wu-Chia Lo ； Wan-Lun Hsu ； San-Lin You

《International Journal of Head and Neck Science》 4卷4期 (2020/12) Pp. 156-163

https://doi.org/10.6696/IJHNS.202012_4(4).0003

摘要

Background: Head and neck cancer (HNC) is one of the most common cancers worldwide. HNC therapy might be associated with swallowing dysfunction. The goals of this study are to determine the prevalence and predictors of subjective problems swallowing in HNC survivors. Methods: This is a cross-sectional study conducted from March 2017 to June 2017 in a medical center in Taiwan. One hundred and sixty-eight cancer survivors were recruited and assessed using the Eating Assessment Tool (EAT)-10 score. If the EAT-10 score was greater than three, patients were regarded as having problems with swallowing. Logistic regression was used to evaluate the significance between the risk factors of interest and the problems with swallowing. Results: Twenty-eight female and 140 male patients (mean age 57.6 ± 9.7 years, mean ± standard deviation) completed the EAT-10 questionnaire. The mean EAT-10 score was 7.4 ± 9.9 (mean ± SD) for these patients. Eighty-seven (51.7%) patients had an EAT-10 score greater than 3. Patients with oropharyngeal cancer (70.8%) and those undergoing traditional treatment-3 dimensional conformal radiation therapy (3D-CRT) led to a higher risk (78.9%) of swallowing dysfunction. Unadjusted logistic regression showed that subjects with oropharyngeal cancer had 3.09 (95% CI: 1.15-8.33) times the risk of problems with swallowing compared to subjects with oral cancer. Volumetric modulated arc therapy and tomotherapy decreased swallowing dysfunction when compared to 3D-CRT. Conclusions: A high proportion (52%, 95% CI: 44-59%) of HNC survivors have problems in swallowing. Patients with oropharyngeal cancer and those undergoing 3D-CRT lead to a higher risk of swallowing dysfunction.

關鍵字

dysphagia ； head and neck cancer ； radiotherapy