Long-term functional outcomes and the patient perspective following altered fractionation with concomitant boost for oropharyngeal cancer

Cartmill, Bena, Cornwall, Petrea, Ward, Elizabeth, Davidson, Wendy and Porceddu, Sandro (2012) Long-term functional outcomes and the patient perspective following altered fractionation with concomitant boost for oropharyngeal cancer. Dysphagia, 27 4: 481-490. doi:10.1007/s00455-012-9394-0

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Author Cartmill, Bena
Cornwall, Petrea
Ward, Elizabeth
Davidson, Wendy
Porceddu, Sandro
Title Long-term functional outcomes and the patient perspective following altered fractionation with concomitant boost for oropharyngeal cancer
Journal name Dysphagia   Check publisher's open access policy
ISSN 0179-051X
1432-0460
Publication date 2012-12-01
Sub-type Article (original research)
DOI 10.1007/s00455-012-9394-0
Open Access Status File (Author Post-print)
Volume 27
Issue 4
Start page 481
End page 490
Total pages 10
Place of publication New York, NY, United States
Publisher Springer
Collection year 2013
Language eng
Abstract With no long-term data available in published research to date, this study presents details of the swallowing outcomes as well as barriers to and facilitators of oral intake and weight maintenance at 2 years after altered fractionation radiotherapy with concomitant boost (AFRT-CB). Twelve patients with T1-T3 oropharyngeal cancer who received AFRT-CB were assessed at baseline, 6 months, and 2 years post-treatment for levels of dysphagia and salivary toxicity, food and fluid tolerance, functional swallowing outcomes, patient-reported function, and weight. At 2 years, participants were also interviewed to explore barriers and facilitators of oral intake. Outcomes were significantly worse at 2 years when compared to baseline for late toxicity, functional swallowing, and patient-rated physical aspects of swallowing. Most patients (83%) tolerated a full diet pretreatment, but the rate fell to 42% (remainder tolerated soft diets) at 2 years. Multiple barriers to oral intake that impacted on activity and participation levels were identified. Participants lost 11 kg from baseline to 2 years, which was not regained between 6 months and 2 years. Global, social, and emotional domains of patient-reported function returned to pretreatment levels. At 2 years post AFRT-CB, worsening salivary and dysphagia toxicity, declining functional swallowing, and multiple reported ongoing barriers to oral intake had a negative impact on participants' activity and participation levels relating to eating. These ongoing deficits contributed to significant deterioration in physical swallowing functioning determined by the MDADI. In contrast, patients perceived their broader functioning had improved at 2 years, suggesting long-term adjustment to ongoing swallowing deficits.
Keyword Altered fractionation radiotherapy
Deglutition
Deglutition disorders
Long-term outcomes
Oropharynx
Squamous cell carcinoma
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 24 February 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Health and Rehabilitation Sciences Publications
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 13 times in Scopus Article | Citations
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Created: Wed, 26 Sep 2012, 20:53:27 EST by Professor Elizabeth Ward on behalf of School of Health & Rehabilitation Sciences