Abstract
Background The purpose of this study was to evaluate long-term outcomes after induction chemotherapy followed by "risk-based" local therapy for locally-advanced squamous cell carcinoma of the head and neck (SCCHN). Methods Forty-seven patients (stage IV; ≥N2b) were enrolled in a phase II trial. Baseline and 24-month functional measures included modified barium swallow (MBS) studies, oropharyngeal swallow efficiency (OPSE), and the MD Anderson Dysphagia Inventory (MDADI). Functional status was assessed at 5 years. Results Five-year overall survival (OS) was 89% (95% confidence interval [CI], 81% to 99%). A nonsignificant 13% average reduction in swallowing efficiency (OPSE) was observed at 24 months relative to baseline (p =.191). MDADI scores approximated baseline at 24 months. Among 42 long-term survivors (median, 5.9 years), 3 patients (7.1%) had chronic dysphagia. The rate of final gastrostomy dependence was 4.8% (2 of 42). Conclusion Sequential chemoradiotherapy achieved favorable outcomes among patients with locally advanced SCCHN, mainly of oropharyngeal origin. MBS and MDADI scores found modest swallowing deterioration at 2 years, and chronic aspiration was uncommon in long-term survivors.
Original language | English (US) |
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Pages (from-to) | 474-480 |
Number of pages | 7 |
Journal | Head and Neck |
Volume | 36 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2014 |
Keywords
- functional outcomes
- induction chemotherapy
- locally advanced squamous carcinoma
- sequential chemoradiotherapy
- swallowing
ASJC Scopus subject areas
- Otorhinolaryngology
MD Anderson CCSG core facilities
- Biostatistics Resource Group
- Clinical Trials Office