Clin Exp Otorhinolaryngol.  2013 Sep;6(3):117-126.

Dysphagia in Head and Neck Cancer Patients: Pretreatment Evaluation, Predictive Factors, and Assessment during Radio-Chemotherapy, Recommendations

• Denaro N
• Merlano MC
• Russi EG

Abstract

Progress in head and neck cancer (HNC) therapies has improved tumor response, loco-regional control, and survival. However, treatment intensification also increases early and late toxicities. Dysphagia is an underestimated symptom in HNC patients. Impairment of swallowing process could cause malnutrition, dehydration, aspiration, and pneumonia. A comprehensive literature review finalized in May 2012 included searches of electronic databases (Medline, Embase, and CAB abstracts) and scientific societies meetings materials (American Society of Clinical Oncology, Associazione Italiana Radioterapia Oncologica, Associazione Italiana di Oncologia Cervico-Cefalica, American Head and Neck Society, and European Society for Medical Oncology). Hand-searches of HNC journals and reference lists were carried out. Approximately one-third of dysphagia patients developed pneumonia requiring treatment. Aspiration pneumonia associated mortality ranged from 20% to 65%. Unidentified dysphagia caused significant morbidity, increased mortality, and decreased the quality of life. In this review we underline definition, causes, predictive factors of dysphagia and report on pretreatment and on-treatment evaluation, suggesting some key points to avoid underestimation. A multi-parameter assessment of swallowing problems may allow an earlier diagnosis. An appropriate evaluation might lead to a better treatment of both symptoms and cancer.

Keyword

Dysphagia; Malnutrition; Weight loss; Head and neck cancer; Chemoradiotherapy; Acute toxicity; Late toxicity

MeSH Terms

Chemoradiotherapy
Deglutition
Deglutition Disorders
Dehydration
Electronics
Electrons
Head
Head and Neck Neoplasms
Humans
Malnutrition
Medical Oncology
Neck
Pneumonia
Pneumonia, Aspiration
Quality of Life
Societies, Scientific
Weight Loss

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