Trends in Swallowing Outcomes Following Deintensified Treatment in Selected p16+ Oropharyngeal Carcinoma

Esther Lee, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.
Hari Magge, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.
Isabel Park, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.
Leyn Shakhtour, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.
Ning-Wei Li, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.
Jennifer Schottler, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.
Arjun S. Joshi, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.
Punam G. Thakkar, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.
Joseph F. Goodman, Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.

Document Type

Journal Article

Publication Date

1-1-2023

Journal

OTO open

Volume

7

Issue

1

DOI

10.1002/oto2.47

Keywords

MD Anderson Dysphagia Inventory; oropharyngeal squamous cell carcinoma; radiation; swallowing; transoral robotic surgery

Abstract

OBJECTIVE: Identify trends in swallowing outcomes in p16+ oropharyngeal squamous cell carcinoma following neoadjuvant chemotherapy+surgery (NAC+S) versus neoadjuvant chemotherapy+surgery+radiation (NAC+S+R). STUDY DESIGN: Cohort study. SETTING: Single academic institution. METHODS: Swallowing outcome was measured using a validated questionnaire, MD Anderson Dysphagia Inventory (MDADI). MDADI scores were compared between NAC+S and NAC+S+R groups in short-term (<1 year), middle-term (1-3 years), and long-term (>3 years). Clinical factors associated with MDADI scores were explored using a linear mixed model. Statistical significance was established at  < .05. RESULTS: Sixty-seven patients met the inclusion criteria and were divided into 2 groups: NAC+S (57 [85.1%]) and NAC+S+R (10 [14.9%]). All patients had improved MDADI scores in the middle-term compared to short-term (NAC+S: score increase = 3.43,  = .002; NAC+S+R: score increase = 11.18,  = .044), long-term compared to short-term (NAC+S: score increase = 6.97,  < .001; NAC+S+R: score increase = 20.35,  < .001), and long-term compared to middle-term (NAC+S: score increase = 3.54,  = .043; NAC+S+R: score increase = 9.18,  = .026). NAC+S patients had better MDADI scores than NAC+S+R patients at short-term (83.80 vs 71.26,  = .001). There was no significant difference in swallowing function in the middle-term or long-term. CONCLUSION: Regardless of treatment type, swallowing will likely be improved in the middle-term and long-term compared to the short-term. Patients treated with NAC+S+R will have worse short-term swallowing function. However, in the middle-term and long-term, there is no significant difference in swallowing function between patients treated with NAC+S and NAC+S+R.

Department

Surgery

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