Download PDF
Int Arch Otorhinolaryngol 2015; 19(01): 046-054
DOI: 10.1055/s-0034-1395790
Original Research
Thieme Publicações Ltda Rio de Janeiro, Brazil

Quality of Life in Swallowing Disorders after Nonsurgical Treatment for Head and Neck Cancer

Marta Halina Silveira
1   Department of Otorhinolaryngology–Head and Neck Surgery, Universidade Metropolitana de Santos, Santos, São Paulo, Brazil
,
Rogerio A. Dedivitis
2   Department of Head and Neck Surgery, Hospital das Clinicas, University of Sao Paulo School of Medicine, Santos, São Paulo, Brazil
,
Débora Santos Queija
1   Department of Otorhinolaryngology–Head and Neck Surgery, Universidade Metropolitana de Santos, Santos, São Paulo, Brazil
,
Paulo César Nascimento
3   Department of Radiotherapy, Irmandade da Santa Casa da Misericórdia de Santos, Santos, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

12 July 2014

11 October 2014

Publication Date:
05 December 2014 (online)

   Permissions and Reprints

Abstract

Introduction Radiotherapy or chemoradiotherapy can result in severe swallowing disorders with potential risk for aspiration and can negatively impact the patient's quality of life (QOL).

Objective To assess swallowing-related QOL in patients who underwent radiotherapy/chemoradiotherapy for head and neck cancer.

Methods We interviewed 110 patients (85 men and 25 women) who had undergone exclusive radiotherapy (25.5%) or concomitant chemoradiotherapy (74.5%) from 6 to 12 months before the study. The Quality of Life in Swallowing Disorders (SWAL-QOL) questionnaire was employed to evaluate dysphagia-related QOL.

Results The QOL was reduced in all domains for all patients. The scores were worse among men. There was a relationship between oral cavity as the primary cancer site and the fatigue domain and also between advanced cancer stage and the impact of food selection, communication, and social function domains. Chemoradiotherapy association, the presence of nasogastric tube and tracheotomy, and the persistence of alcoholism and smoking had also a negative effect on the QOL.

Conclusions According to the SWAL-QOL questionnaire, the dysphagia-related impact on QOL was observed 6 to 12 months after the treatment ended.

Keywords

head and neck neoplasms - dysphagia - deglutition disorders - quality of life - radiotherapy - chemotherapy
 

  • References

  • 1 Pauloski BR, Rademaker AW, Logemann JA , et al. Relationship between swallow motility disorders on videofluorography and oral intake in patients treated for head and neck cancer with radiotherapy with or without chemotherapy. Head Neck 2006; 28 (12) 1069-1076
    CrossrefGoogle Scholar
  • 2 Eisbruch A, Lyden T, Bradford CR , et al. Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head-and-neck cancer. Int J Radiat Oncol Biol Phys 2002; 53 (1) 23-28
    CrossrefGoogle Scholar
  • 3 Graner DE, Foote RL, Kasperbauer JL , et al. Swallow function in patients before and after intra-arterial chemoradiation. Laryngoscope 2003; 113 (3) 573-579
    CrossrefGoogle Scholar
  • 4 Kotz T, Costello R, Li Y, Posner MR. Swallowing dysfunction after chemoradiation for advanced squamous cell carcinoma of the head and neck. Head Neck 2004; 26 (4) 365-372
    CrossrefGoogle Scholar
  • 5 Platteaux N, Dirix P, Dejaeger E, Nuyts S. Dysphagia in head and neck cancer patients treated with chemoradiotherapy. Dysphagia 2010; 25 (2) 139-152
    CrossrefGoogle Scholar
  • 6 Nuyts S, Dirix P, Clement PM , et al. Impact of adding concomitant chemotherapy to hyperfractionated accelerated radiotherapy for advanced head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 2009; 73 (4) 1088-1095
    CrossrefGoogle Scholar
  • 7 Nguyen NP, Moltz CC, Frank C , et al. Dysphagia following chemoradiation for locally advanced head and neck cancer. Ann Oncol 2004; 15 (3) 383-388
    CrossrefGoogle Scholar
  • 8 McHorney CA, Bricker DE, Kramer AE , et al. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: I. Conceptual foundation and item development. Dysphagia 2000; 15 (3) 115-121
    Google Scholar
  • 9 McHorney CA, Bricker DE, Robbins J, Kramer AE, Rosenbek JC, Chignell KA. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: II. Item reduction and preliminary scaling. Dysphagia 2000; 15 (3) 122-133
    Google Scholar
  • 10 McHorney CA, Robbins J, Lomax K , et al. The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia 2002; 17 (2) 97-114
    Google Scholar
  • 11 Portas JG. Validação para a língua portuguesa-brasileira dos questionários: qualidade de vida em disfagia (SWAL-QOL) e satisfação do paciente e qualidade do cuidado no tratamento da disfagia (SWAL-CARE) [Dissertação]. São Paulo, Brazil: Fundação Antônio Prudente; 2009
    Google Scholar
  • 12 Rinkel RN, Verdonck-de Leeuw IM, Langendijk JA, van Reij EJ, Aaronson NK, Leemans CR. The psychometric and clinical validity of the SWAL-QOL questionnaire in evaluating swallowing problems experienced by patients with oral and oropharyngeal cancer. Oral Oncol 2009; 45 (8) e67-e71
    CrossrefGoogle Scholar
  • 13 Gillespie MB, Brodsky MB, Day TA, Lee FS, Martin-Harris B. Swallowing-related quality of life after head and neck cancer treatment. Laryngoscope 2004; 114 (8) 1362-1367
    CrossrefGoogle Scholar
  • 14 Nguyen NP, Frank C, Moltz CC , et al. Impact of dysphagia on quality of life after treatment of head-and-neck cancer. Int J Radiat Oncol Biol Phys 2005; 61 (3) 772-778
    CrossrefGoogle Scholar
  • 15 van Bokhorst, de van der Schuer, van Leeuwen PA et al. The impact of nutritional status on the prognoses of patients with advanced head and neck cancer. Cancer 1999; 86 (3) 519-527
    CrossrefGoogle Scholar
  • 16 Shune SE, Karnell LH, Karnell MP, Van Daele DJ, Funk GF. Association between severity of dysphagia and survival in patients with head and neck cancer. Head Neck 2012; 34 (6) 776-784
    CrossrefGoogle Scholar
  • 17 Frowen J, Cotton S, Corry J, Perry A. Impact of demographics, tumor characteristics, and treatment factors on swallowing after (chemo)radiotherapy for head and neck cancer. Head Neck 2010; 32 (4) 513-528
    Google Scholar
  • 18 Langendijk JA, Doornaert P, Rietveld DH, Verdonck-de Leeuw IM, Leemans CR, Slotman BJ. A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer. Radiother Oncol 2009; 90 (2) 189-195
    CrossrefGoogle Scholar
  • 19 Koiwai K, Shikama N, Sasaki S, Shinoda A, Kadoya M. Validation of the Total Dysphagia Risk Score (TDRS) as a predictive measure for acute swallowing dysfunction induced by chemoradiotherapy for head and neck cancers. Radiother Oncol 2010; 97 (1) 132-135
    CrossrefGoogle Scholar
  • 20 List MA, Siston A, Haraf D , et al. Quality of life and performance in advanced head and neck cancer patients on concomitant chemoradiotherapy: a prospective examination. J Clin Oncol 1999; 17 (3) 1020-1028
    Google Scholar
  • 21 Saltman B, Kraus DH, Szeto H , et al. In vivo and in vitro models of ionizing radiation to the vocal folds. Head Neck 2010; 32 (5) 572-577
    Google Scholar
  • 22 Kim JP, Khalmuratova R, Jeon SY , et al. Quantitative analysis of myosin heavy chain expression change in laryngeal muscle after irradiation in rats. Yonsei Med J 2011; 52 (1) 158-164
    CrossrefGoogle Scholar
  • 23 Lazarus CL. Effects of chemoradiotherapy on voice and swallowing. Curr Opin Otolaryngol Head Neck Surg 2009; 17 (3) 172-178
    CrossrefGoogle Scholar
  • 24 Langendijk JA, Doornaert P, Verdonck-de Leeuw IM, Leemans CR, Aaronson NK, Slotman BJ. Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy. J Clin Oncol 2008; 26 (22) 3770-3776
    CrossrefGoogle Scholar
  • 25 Murry T, Madasu R, Martin A, Robbins KT. Acute and chronic changes in swallowing and quality of life following intraarterial chemoradiation for organ preservation in patients with advanced head and neck cancer. Head Neck 1998; 20 (1) 31-37
    CrossrefGoogle Scholar
  • 26 Langius JAE, van Dijk AM, Doornaert P , et al. More than 10% weight loss in head and neck cancer patients during radiotherapy is independently associated with deterioration in quality of life. Nutr Cancer 2013; 65 (1) 76-83
    CrossrefGoogle Scholar
  • 27 Mouw KW, Solanki AA, Stenson KM , et al. Performance and quality of life outcomes for T4 laryngeal cancer patients treated with induction chemotherapy followed by chemoradiotherapy. Oral Oncol 2012; 48 (10) 1025-1030
    CrossrefGoogle Scholar
  • 28 So WK, Chan RJ, Chan DN , et al. Quality-of-life among head and neck cancer survivors at one year after treatment—a systematic review. Eur J Cancer 2012; 48 (15) 2391-2408
    CrossrefGoogle Scholar
  • 29 Queija DdosS, Portas JG, Dedivitis RA, Lehn CN, Barros APB. Swallowing and quality of life after total laryngectomy and pharyngolaryngectomy. Braz J Otorhinolaryngol 2009; 75 (4) 556-564
    CrossrefGoogle Scholar
  • 30 McHorney CA, Martin-Harris B, Robbins J, Rosenbek J. Clinical validity of the SWAL-QOL and SWAL-CARE outcome tools with respect to bolus flow measures. Dysphagia 2006; 21 (3) 141-148
    CrossrefGoogle Scholar