Open AccessSwallow Preservation Exercises during Chemoradiation Therapy Maintains Swallow Function
Author(s) -
Duarte Victor M.,
Chhetri Dinesh K.,
Liu Yuan F.,
Erman Andrew A.,
Wang Marilene B.
Publication year - 2013
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599813502310
Subject(s) - medicine , swallowing , head and neck cancer , feeding tube , radiation therapy , odynophagia , dysphagia , gastrostomy tube , gastrostomy , surgery , physical therapy
Objective To evaluate a swallow preservation protocol (SPP) in which patients received swallow therapy before, during, and after radiation treatment and its efficacy in maintaining swallowing function in head and neck cancer patients. Design Case series with chart review. Setting Tertiary care academic medical center. Subjects and Methods Eighty‐five patients who received radiation (RT) or chemoradiation (CRT) participated in the SPP from 2007 to 2012. Subjects were divided into 2 groups: compliant and noncompliant with SPP. At each SPP visit, the diet of each patient was recorded as regular (chewable), puree, liquid, or gastrostomy tube (G‐tube) dependent, along with their compliance with the swallow exercises. Patients were stratified by age, gender, tumor stage, type of treatment, radiation dose, diet change, dysguesia, odynophagia, pain, and stenosis. Statistical analysis was performed comparing the 2 compliance groups in regards to swallowing‐related outcomes at 1 month after completion of therapy. Results Fifty‐seven patients were compliant and 28 were noncompliant with SPP during treatment. The compliant group had a higher percentage of patients tolerating a regular diet (54.4% vs 21.4%, P =. 008), a lower G‐tube dependence (22.8% vs 53.6%, P =. 008), and a higher rate of maintaining or improving their diet (54.4% vs 25.0%, P =. 025) compared to noncompliant patients. Conclusion A swallow preservation protocol appears to help maintain or improve swallow function in head and neck cancer patients undergoing RT or CRT. Patients who are able to comply with swallow exercises are less likely to worsen their diet, receive a G‐tube, or develop stenosis.