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Transoral laser microsurgery ± adjuvant therapy versus chemoradiotherapy for stage III and IVA oropharyngeal squamous cell carcinoma: Preliminary comparison of early swallowing outcomes
Author(s) -
O'Hara James,
Cosway Benjamin,
Muirhead Colin,
Leonard Nicola,
Goff Diane,
Patterson Joanne
Publication year - 2015
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23790
Subject(s) - medicine , swallowing , dysphagia , chemoradiotherapy , transoral laser microsurgery , stage (stratigraphy) , surgery , microsurgery , radiation therapy , head and neck cancer , paleontology , biology
Background Observational data suggests transoral surgery may offer benefit in swallowing over chemoradiotherapy. Methods In this preliminary, non‐randomized study, patients with stage III and IVA oropharyngeal carcinoma treated with transoral laser microsurgery (TLM) were assessed pretreatment and 3 months after treatment using the MD Anderson Dysphagia Inventory (MDADI), the Performance Status Scale (PSS), and a timed Water Swallow Test (WST). Comparisons were made with a historical chemoradiotherapy (CRT) cohort. Results Based on patients with measurements at both times, the decrease in score between baseline and 3 months was greater for CRT patients ( n = 26–28) than for TLM ( n = 20–21) patients for each of MDADI, PSS, and WST. A repeated measures analysis that looked at all 3 scores simultaneously and allowed for missing values gave mostly similar results (except for MDADI). Conclusion TLM was associated with good early swallowing outcomes at 3 months and may offer a benefit over CRT. The results should be viewed as preliminary data, providing useful reference for any proposed controlled trial. © 2015 Wiley Periodicals, Inc. Head Neck 37: 1488–1494, 2015