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Association between external and internal lymphedema and chronic dysphagia following head and neck cancer treatment
Author(s) -
Jeans Claire,
Ward Elizabeth C.,
Brown Bena,
Vertigan Anne E.,
Pigott Amanda E.,
Nixon Jodie L.,
Wratten Chris,
Boggess May
Publication year - 2021
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.26484
Subject(s) - medicine , dysphagia , swallowing , lymphedema , head and neck cancer , radiation therapy , surgery , cancer , breast cancer
Background To examine the relationship between chronic external and internal head and neck lymphedema (HNL) and swallowing function in patients following head and neck cancer (HNC) treatment. Methods Seventy‐nine participants, 1‐3 years post treatment were assessed for external HNL using the MD Anderson Cancer Centre Lymphedema Rating Scale, and internal HNL using Patterson's Radiotherapy Edema Rating Scale. Swallowing was assessed via instrumental, clinical and patient‐reported outcome measures. Results HNL presented as internal only (68%), combined external/internal (29%), and external only (1%). Laryngeal penetration/aspiration was confirmed in 20%. Stepwise multivariable regression models, that accounted for primary site, revealed that a higher severity of external HNL and internal HNL was associated with more severe penetration/aspiration ( P < .004 and P = .006, respectively), diet modification ( P < .001 both), and poorer patient‐reported outcomes ( P = .037 and P = .014, respectively). Conclusion Increased swallowing issues can be expected in patients presenting with more severe external HNL and/or internal HNL following HNC treatment.