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Journal article
Gastrostomy Utilization by Oropharyngeal Cancer Patients Is Partially Driven by Swallowing Function
The Laryngoscope, Vol.130(9), pp.2153-2159
09/2020
PMID: 31566749
Web of Science ID: WOS:000488584400001
Abstract
Objective
Oropharyngeal squamous cell carcinoma (OPSCC) incidence is rapidly increasing, as are survival rates, in large part due to the human papillomavirus (HPV). Treatment intensity, however, has remained unchanged, making treatment‐related toxicity (i.e., dysphagia) a critical problem for an increasing number of patients. The primary objective of this study was to determine whether pretreatment objective swallowing measures can predict percutaneous fluoroscopic guided gastrostomy tube (PFG) utilization during OPSCC treatment.
Methods
Forty‐one newly diagnosed OPSCC patients treated with radiation underwent evaluation of swallow function with modified barium swallow study (MBSS) prior to and at completion of radiation treatment using the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST); a subset of patients were evaluated using the MD Anderson Dysphagia Inventory (MDADI).
Results
Patients were male (100%), primarily Caucasian (85.4%) and p16 positive (85.4%) with mean age of 65.7 years. PFG were placed in 70.7% patients (n = 29) and used by 63.4% (n = 26). Pre‐ and post‐treatment DIGEST scores were associated with T‐classification (t = −2.9, p = .001, t = −2.7, p = .01) and indicated deteriorating swallow function during treatment (mean change = 0.46 [t = −2.7, p = .01]). DIGEST and MDADI scores were generally not associated with patient PFG utilization. DIGEST and MDADI scores were significantly correlated prior to, but not following completion of treatment.
Conclusion
Pre‐treatment DIGEST and patient reported swallowing outcomes (MDADI) can be useful in identifying patients with unsafe and/or grossly inefficient swallowing function. However, objectively measured swallow function was not associated with PFG utilization. Development of PFG placement algorithms (reactive vs. prophylactic) therefore require additional inputs/metrics.
Level of Evidence
4 Laryngoscope, 130:2153–2159, 2020
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Details
- Title
- Gastrostomy Utilization by Oropharyngeal Cancer Patients Is Partially Driven by Swallowing Function
- Publication Details
- The Laryngoscope, Vol.130(9), pp.2153-2159
- Resource Type
- Journal article
- Publisher
- John Wiley & Sons, Inc
- Copyright
- © 2019 The American Laryngological, Rhinological and Otological Society, Inc.
- Identifiers
- WOS:000488584400001; 99380466997006600
- Academic Unit
- Public Health; Usha Kundu, MD College of Health
- Language
- English