Long-term swallowing after chemoradiotherapy: Prospective study of functional and patient-reported changes over time

Background. This prospective study evaluated long-term swallowing outcomes and associated risk factors 5 years postchemoradiotherapy for head and neck cancer. Methods. Following an earlier study of 69 patients, 39 patients had patient-reported activity and quality of life (QOL) data collected. Twenty-one patients also underwent a videofluoroscopy swallowing study (VFSS). Results. Between 6 months and 5 years posttreatment, patient-reported activity for solid foods significantly improved (p<.001), returning to pretreatment levels for 74% of patients. On VFSS, swallowing function for semisolids declined, with 5 patients demonstrating a clinically significant deterioration. Factors that predicted poorer long-term swallowing were the same as at 6 months, with the addition of older age and disease stage. Conclusion. Although long-term patient-reported activity improves and swallowing-related QOL is high, up to 24% of patients may demonstrate a clinically significant deterioration in swallowing function at 5 years posttreatment. This divergence suggests a degree of adaptation that patients develop, which warrants further investigation. (C) 2015 Wiley Periodicals, Inc.