Analysis of factors influencing aspiration risk following chemoradiation for oropharyngeal cancer

¹ Department of Radiation Oncology, University of Arizona, Tucson, AZ, Greece
² Speech Pathology, VA North Texas Health Care System, Dallas, TX, Greece
³ Biostatistics, East Carolina University, Greenville, NC, Greece
⁴ Radiology, Greece
⁵ Radiation Oncology, VA North Texas Health Care System, Dallas, TX, Greece
⁶ Department of Radiation Oncology, East Carolina University, Greenville, NC, Greece
⁷ Department of Radiation Oncology, University of Southern California, Los Angeles, LA, Greece
⁸ Department of Radiation Oncology, Centre Val D'Aurelle, Montpellier, France, Greece
⁹ School of Public Health, University of Michigan, Ann Arbor, MI, USA, Greece
¹⁰ Division of Hematology Research, Novonordisk, Athens, Greece

	Abstract

Our aim was to identify risk factors for aspiration following concurrent chemoradiation for oropharyngeal cancer. 46 patients with locally advanced oropharyngeal carcinoma underwent concurrent chemoradiation at our institution. All patients underwent modified barium swallow to assess dysphagia severity and to determine the need for continued tube feedings after treatment. Dysphagia severity was graded as 1–7. There were 5 Grade 2, 11 Grade 3, 5 Grade 4, 5 Grade 5, 10 Grade 6 and 10 Grade 7 scores. 25 patients (54%) developed aspiration (5 trace, 20 severe). The aspiration rate for T1–T2 and T3–T4 tumours was 31% and 67%, respectively (p = 0.03). There was no statistical difference in the aspiration rate between the base of the tongue and tonsillar carcinoma (p = 0.23). Despite anatomic organ preservation, most patients with locally advanced oropharyngeal carcinoma had moderate to severe dysphagia after chemoradiation. Patients with large tumours had a significant risk of developing aspiration following treatment.