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M. Boyd Gillespie, MD; Martin B. Brodsky, MA; Terry A. Day, MD; Anand K. Sharma, MD; Fu-shing Lee, PhD; Bonnie Martin-Harris, PhD

Arch Otolaryngol Head Neck Surg. 2005;131:615-619.

Objective  To determine whether laryngeal penetration and aspiration in oropharyngeal cancer survivors differ by treatment group.

Design  Cross-sectional study of patients with stage III or IV oropharyngeal squamous cell carcinoma who were at least 12 months removed from combined modality therapy and clinically free of disease.

Subjects  Potential subjects were stratified by tumor site and tumor T stage to achieve a similar comparison between chemoradiotherapy (n = 10) and surgery/radiotherapy (n = 11) groups. Validated instruments used to evaluate swallowing included the Penetration-Aspiration Scale and the M. D. Anderson Dysphagia Inventory.

Results  Patients with oropharyngeal cancer treated with chemoradiotherapy demonstrated greater airway protection according to Penetration-Aspiration Scale scores than those treated with surgery and radiotherapy on 5-mL (P = .02), 10-mL (P = .04), and 20-mL (P = .04) liquid barium swallows. Also, the oropharyngeal chemoradiotherapy group had better self-perceived swallowing ability than the surgery-radiotherapy group on the basis of the M. D. Anderson Dysphagia Inventory (P = .02).

Conclusion  The present study suggests that patients with oropharyngeal cancer who successfully complete chemoradiotherapy protocols without surgical salvage retain greater airway protection during swallowing and better swallowing-related quality of life than patients treated with primary surgery and radiotherapy.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston.

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