Functional and patient-reported changes in swallowing and voice after combined chemotherapy and radiotherapy for limited-stage small-cell lung cancer.

Introduction: The purpose of this study was to describe the nature and impact of dysphagia and dysphonia in patients with limited-stage small-cell lung cancer (SCLC) before and after chemoradiation.

Methods: A prospective cohort study was conducted on patients receiving chemoradiotherapy for limited-stage SCLC. Patients received either 40, 45 or 50 Gy, commencing the second cycle of chemotherapy.

Introduction of a speech-language pathology assistant role for swallow screening in a head and neck radiotherapy clinic.

Purpose: Optimal care suggests that all moderate-high risk head and neck (H&N) cancer patients should receive speech pathology assessment, education and management when commencing radiotherapy. However this is not always feasible due to high patient numbers and limited staffing. The aim of this study was to investigate the implementation of a speech-language pathology assistant (SLP-A) role for swallowing screening and education in a multidisciplinary H&N treatment clinic.

The prevalence of patient-reported dysphagia and oral complications in cancer patients.

Purpose: Research investigating swallowing problems (dysphagia) and complications within the oral cavity in non-head and neck cancer patients is limited. The purpose of this study was to determine the prevalence of patient-reported dysphagia and oral complications in all cancer patients and to examine the relationships between cancer types, oral complications and dysphagia.

Methods: A cross-sectional study was conducted at a specialist cancer centre in Australia.

Dysphagia in patients with non-head and neck cancer.

Purpose Of Review: To review the current evidence on dysphagia in non-head and neck cancer, including its cause, prevalence, impact, management, and areas for future research.

Recent Findings: Dysphagia is widely recognised as a common and debilitating side-effect of head and neck cancer (HNC) and its treatment; however, minimal attention has been given to dysphagia in other cancer populations. Detailed data regarding the exact nature and prevalence of dysphagia are limited, in part because of the lack of any validated tools specifically for non-HNC patients.

Evaluating the effectiveness of a nutrition assistant role in a head and neck cancer clinic.

Aim: Acute toxicities secondary to (chemo)radiation for head and neck cancer can substantially impact nutritional intake. Nutrition is usually managed by dietitians, although time constraints may limit capacity to sufficiently deal with complex nutritional issues. The aim of the present study was to determine the effectiveness of a nutrition assistant performing screening and intervention of patients in a multidisciplinary head and neck clinic.

Voice Outcomes after Radiotherapy Treatment for Early Glottic Cancer: Long-Term Follow-Up.

Objectives: The aim of this study was to investigate long-term voice outcomes and voice-related quality of life (QOL) for early glottic cancer treated with radiotherapy.

Study Design: Long-term exploratory follow-up study of a prospective patient cohort comparing outcomes at a mean of 11 years postradiotherapy with the original 1-year posttreatment results.

Method: Eight patients completed voice tasks for auditory perception and acoustic and aerodynamic measures.

Long-term swallowing after chemoradiotherapy: Prospective study of functional and patient-reported changes over time.

Background: This prospective study evaluated long-term swallowing outcomes and associated risk factors 5 years postchemoradiotherapy for head and neck cancer.

Methods: Following an earlier study of 69 patients, 39 patients had patient-reported activity and quality of life (QOL) data collected. Twenty-one patients also underwent a videofluoroscopy swallowing study (VFSS).

Reducing posttreatment dysphagia: Support for the relationship between radiation dose to the pharyngeal constrictors and swallowing outcomes.

Purpose: This study used prospective swallowing data to establish the following: (1) whether doses to the pharyngeal constrictor muscles (PCMs) were significantly associated with swallowing outcomes; and (2) a mean dose constraint to aim for in intensity modulated radiation therapy planning.

Methods And Materials: The PCMs were contoured and radiation dose data obtained for 55 patients with head and neck cancer. Associations between radiation dose and percentage of pharyngeal residue, penetration-aspiration and activity limitation measured at 6 months posttreatment were analyzed.

Impact of demographics, tumor characteristics, and treatment factors on swallowing after (chemo)radiotherapy for head and neck cancer.

Background: This prospective study evaluated the impact of patient demographics, tumor characteristics, and radiotherapy treatment on swallowing before and after radiotherapy or chemoradiotherapy.

Methods: Eighty-one patients with head and neck cancer were examined using videofluoroscopy swallowing studies (VFSS) before treatment and again at 3 and 6 months after treatment.

Results: Swallowing was best at baseline, significantly worse 3 months posttreatment, and improved by 6 months posttreatment.

The stability, reliability, and validity of videofluoroscopy measures for patients with head and neck cancer.

The purpose of this study was to contrast the psychometric properties (stability, test-retest reliability, construct, and concurrent validity) of three different tools used for evaluating videofluoroscopy swallowing studies (VFSS): (1) rating the presence or absence of a swallowing disorder, (2) the Bethlehem Assessment Scale (BAS), and (3) biomechanical measures. These three tools were applied to the same three examinations of two different consistencies (liquid and semisolid), taken from 40 VFSSs of patients with head and neck (H&N) cancer. Stability of swallowing across three swallows was a concern for three measures with the liquid consistency and nine measures with the semisolid consistency.

Swallowing outcomes after radiotherapy for head and neck cancer: a systematic review.

Background: A systematic review of the current data on swallowing function after radiotherapy or chemoradiotherapy is presented.

Methods: Electronic databases were searched for 1966-2005. Papers were categorized according to level of evidence, methodological quality, and the specific domain of swallowing being measured.