Late-onset swallowing outcomes post-treatment for head and neck cancer in a UK-based population

BACKGROUND: Adverse swallowing outcomes following head and neck squamous cell carcinoma treatment in the context of late-onset post-radiotherapy changes can occur more than five years post-treatment. METHODS: A retrospective study was conducted utilising patient records from March 2013 to April 2015. Patients were categorised into ‘swallow dysfunction’ and ‘normal swallow’ groups. Quality of life was investigated using the MD Anderson Dysphagia Inventory and EuroQol questionnaires. RESULTS: Swallow dysfunction was seen in 77 (51 per cent) of 152 patients. Twenty-eight patients (36 per cent) in the swallow dysfunction group reported symptoms in year five. Swallow dysfunction was associated with stage IV head and neck squamous cell carcinoma (p < 0.001) and radiotherapy (p < 0.001). MD Anderson Dysphagia Inventory global scores showed significant differences between swallow dysfunction and normal swallow groups (p = 0.01), and radiotherapy and surgery groups (p = 0.03), but there were no significant differences between these groups in terms of MD Anderson Dysphagia Inventory composite or EuroQol five-dimensions instrument scores. CONCLUSION: One-third of head and neck squamous cell carcinoma survivors with swallow dysfunction still show symptoms at more than five years post-surgery, a point at which they are typically discharged.