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Many Factors Affect Speaking, Swallowing Outcomes in Cancer

Study IDs factors tied to outcomes in head, neck cancer patients treated with chemoradiotherapy

THURSDAY, Dec. 23 (HealthDay News) -- Factors including gender, smoking history, cancer site, and age correlate with speaking and swallowing outcomes among patients successfully treated for locoregionally advanced cancers of the head and neck, according to a study published in the December issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Kent W. Mouw, M.D., Ph.D., of the University of Chicago, and colleagues assigned speaking and swallowing scores at follow-up ranging from one to four (one representing normal speech or swallowing and four representing significant sustained deficit) to 184 patients with locoregionally advanced head and neck cancer. The subjects were previously enrolled in a phase 2 trial using induction chemotherapy consisting of carboplatin and paclitaxel followed by chemoradiotherapy with paclitaxel, fluorouracil, hydroxyurea, and one of three radiation dose levels.

The investigators assigned a speaking score of one to four to 163 patients (88.6 percent) at an average of 34.8 months after completion of treatment, with 166 patients (90.2 percent) assigned a swallowing score of one to four at an average of 34.5 months after treatment completion. The investigators found that 84.7 percent with speaking scores and 63.3 percent with swallowing scores had no residual deficit and were assigned scores of one. While female sex, smoking history, hypopharyngeal or laryngeal primary sites, and poor response to induction chemotherapy were associated with worse speaking outcomes, advanced patient age, poor performance status, primary site, and neck dissection were associated with worse swallowing outcomes.

"Among patients successfully treated for locoregionally advanced cancers of the head and neck, several factors correlate with speaking and swallowing outcomes," the authors write. "Because advances in therapy have led to improved survival in these patients, understanding and controlling adverse effects of treatment should continue to be an active area of investigation."

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