Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea

Initial results

Richard V. Smith, Tamar Kotz, Jonathan J. Beitler, Scott Wadler

Research output: Contribution to journalArticle

142 Citations (Scopus)

Abstract

Objective: To evaluate the long-term effects on swallowing function of concomitant continuous infusion hydroxyurea and hyperfractionated radiation therapy used to treat advanced head and neck carcinoma. Design: A prospective evaluation of swallowing function was performed on an inception cohort by analyzing posttreatment videoflouroscopic swallow function studies using radiological descriptors for pharyngeal transport abnormalities and temporal measures of structural movements, as well as by conducting patient interviews to assess alimentation, more than 1 year after tumor treatment (range, 52-124 weeks; median, 70 weeks). Setting: Academic tertiary care referral medical center. Patients: Ten patients, aged 44 to 71 years, with stage III and IV squamous cell carcinoma of the oral cavity, oropharynx, or hypopharynx. Main Outcome Measure: Radiographic and temporal swallow abnormalities, as well as functional status, were documented and compared with published norms and results of earlier swallowing studies when possible. Results: Pharyngeal transport dysfunction and anterior segment abnormalities, manifested by epiglottic dysmotility, vallecular residue, laryngeal penetration or aspiration, were evident in all 10 patients. Posterior segment abnormalities, such as pharyngeal stasis, constrictor dysmotility and piriform residue were documented in 8 patients. Three patients developed late aspiration, and the majority of patients showed persistent or worsened delay in laryngeal movement compared with their earlier posttreatment evaluations. Also, 3 patients developed a hypopharyngeal stricture, and 6 patients continued to require gastrostomy tube supplementation beyond 1 year. There was no association between site of primary, duration to swallowing evaluation, and severity of dysfunction. Conclusion: Prolonged and debilitating functional swallowing abnormalities may occur after this aggressive concomitant chemotherapy and radiotherapy regimen.

Original languageEnglish (US)
Pages (from-to)384-389
Number of pages6
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume126
Issue number3
StatePublished - Mar 2000

Fingerprint

Organ Preservation
Hydroxyurea
Deglutition
Radiotherapy
Therapeutics
Hypopharynx
Oropharynx
Gastrostomy
Tertiary Healthcare
Mouth
Squamous Cell Carcinoma
Pathologic Constriction
Neck
Referral and Consultation
Head
Outcome Assessment (Health Care)
Interviews
Carcinoma
Drug Therapy

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea : Initial results. / Smith, Richard V.; Kotz, Tamar; Beitler, Jonathan J.; Wadler, Scott.

In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 126, No. 3, 03.2000, p. 384-389.

Research output: Contribution to journalArticle

@article{486d1ad031164d03b38f667ba0863c2b,
title = "Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea: Initial results",
abstract = "Objective: To evaluate the long-term effects on swallowing function of concomitant continuous infusion hydroxyurea and hyperfractionated radiation therapy used to treat advanced head and neck carcinoma. Design: A prospective evaluation of swallowing function was performed on an inception cohort by analyzing posttreatment videoflouroscopic swallow function studies using radiological descriptors for pharyngeal transport abnormalities and temporal measures of structural movements, as well as by conducting patient interviews to assess alimentation, more than 1 year after tumor treatment (range, 52-124 weeks; median, 70 weeks). Setting: Academic tertiary care referral medical center. Patients: Ten patients, aged 44 to 71 years, with stage III and IV squamous cell carcinoma of the oral cavity, oropharynx, or hypopharynx. Main Outcome Measure: Radiographic and temporal swallow abnormalities, as well as functional status, were documented and compared with published norms and results of earlier swallowing studies when possible. Results: Pharyngeal transport dysfunction and anterior segment abnormalities, manifested by epiglottic dysmotility, vallecular residue, laryngeal penetration or aspiration, were evident in all 10 patients. Posterior segment abnormalities, such as pharyngeal stasis, constrictor dysmotility and piriform residue were documented in 8 patients. Three patients developed late aspiration, and the majority of patients showed persistent or worsened delay in laryngeal movement compared with their earlier posttreatment evaluations. Also, 3 patients developed a hypopharyngeal stricture, and 6 patients continued to require gastrostomy tube supplementation beyond 1 year. There was no association between site of primary, duration to swallowing evaluation, and severity of dysfunction. Conclusion: Prolonged and debilitating functional swallowing abnormalities may occur after this aggressive concomitant chemotherapy and radiotherapy regimen.",
author = "Smith, {Richard V.} and Tamar Kotz and Beitler, {Jonathan J.} and Scott Wadler",
year = "2000",
month = "3",
language = "English (US)",
volume = "126",
pages = "384--389",
journal = "Archives of Otolaryngology",
issn = "2168-6181",
publisher = "American Medical Association",
number = "3",

}

TY - JOUR

T1 - Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea

T2 - Initial results

AU - Smith, Richard V.

AU - Kotz, Tamar

AU - Beitler, Jonathan J.

AU - Wadler, Scott

PY - 2000/3

Y1 - 2000/3

N2 - Objective: To evaluate the long-term effects on swallowing function of concomitant continuous infusion hydroxyurea and hyperfractionated radiation therapy used to treat advanced head and neck carcinoma. Design: A prospective evaluation of swallowing function was performed on an inception cohort by analyzing posttreatment videoflouroscopic swallow function studies using radiological descriptors for pharyngeal transport abnormalities and temporal measures of structural movements, as well as by conducting patient interviews to assess alimentation, more than 1 year after tumor treatment (range, 52-124 weeks; median, 70 weeks). Setting: Academic tertiary care referral medical center. Patients: Ten patients, aged 44 to 71 years, with stage III and IV squamous cell carcinoma of the oral cavity, oropharynx, or hypopharynx. Main Outcome Measure: Radiographic and temporal swallow abnormalities, as well as functional status, were documented and compared with published norms and results of earlier swallowing studies when possible. Results: Pharyngeal transport dysfunction and anterior segment abnormalities, manifested by epiglottic dysmotility, vallecular residue, laryngeal penetration or aspiration, were evident in all 10 patients. Posterior segment abnormalities, such as pharyngeal stasis, constrictor dysmotility and piriform residue were documented in 8 patients. Three patients developed late aspiration, and the majority of patients showed persistent or worsened delay in laryngeal movement compared with their earlier posttreatment evaluations. Also, 3 patients developed a hypopharyngeal stricture, and 6 patients continued to require gastrostomy tube supplementation beyond 1 year. There was no association between site of primary, duration to swallowing evaluation, and severity of dysfunction. Conclusion: Prolonged and debilitating functional swallowing abnormalities may occur after this aggressive concomitant chemotherapy and radiotherapy regimen.

AB - Objective: To evaluate the long-term effects on swallowing function of concomitant continuous infusion hydroxyurea and hyperfractionated radiation therapy used to treat advanced head and neck carcinoma. Design: A prospective evaluation of swallowing function was performed on an inception cohort by analyzing posttreatment videoflouroscopic swallow function studies using radiological descriptors for pharyngeal transport abnormalities and temporal measures of structural movements, as well as by conducting patient interviews to assess alimentation, more than 1 year after tumor treatment (range, 52-124 weeks; median, 70 weeks). Setting: Academic tertiary care referral medical center. Patients: Ten patients, aged 44 to 71 years, with stage III and IV squamous cell carcinoma of the oral cavity, oropharynx, or hypopharynx. Main Outcome Measure: Radiographic and temporal swallow abnormalities, as well as functional status, were documented and compared with published norms and results of earlier swallowing studies when possible. Results: Pharyngeal transport dysfunction and anterior segment abnormalities, manifested by epiglottic dysmotility, vallecular residue, laryngeal penetration or aspiration, were evident in all 10 patients. Posterior segment abnormalities, such as pharyngeal stasis, constrictor dysmotility and piriform residue were documented in 8 patients. Three patients developed late aspiration, and the majority of patients showed persistent or worsened delay in laryngeal movement compared with their earlier posttreatment evaluations. Also, 3 patients developed a hypopharyngeal stricture, and 6 patients continued to require gastrostomy tube supplementation beyond 1 year. There was no association between site of primary, duration to swallowing evaluation, and severity of dysfunction. Conclusion: Prolonged and debilitating functional swallowing abnormalities may occur after this aggressive concomitant chemotherapy and radiotherapy regimen.

UR - http://www.scopus.com/inward/record.url?scp=0034095249&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034095249&partnerID=8YFLogxK

M3 - Article

VL - 126

SP - 384

EP - 389

JO - Archives of Otolaryngology

JF - Archives of Otolaryngology

SN - 2168-6181

IS - 3

ER -