Document Detail

Dysphagia after chemoradiation: analysis by modified barium swallow.
MedLine Citation:
PMID:  18074669     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to describe the findings of modified barium swallow study after chemoradiation in patients with head and neck cancer and to correlate these findings with clinical variables, including gastrostomy tube dependence and clinical pneumonia. METHODS: We retrospectively reviewed 49 patients at a tertiary care center who underwent modified barium swallow study for dysphagia after chemoradiation. RESULTS: Patients with nonlaryngeal lesions had increased cricopharyngeal impairment (27.8% versus 0.0%; p = .04). Patients who underwent concomitant chemotherapy had increased epiglottic changes relative to those who had radiotherapy alone (66.7% versus 30.8%; p = .05). Clinical pneumonia developed in 31.9% of the patients, and 79.6% required gastrostomy tube placement for a mean duration of 18.1 months. CONCLUSIONS: Chemoradiation effects deglutition at multiple levels. A large percentage of patients will develop pneumonia and feeding tube dependence. This study is among the largest to correlate the results of modified barium swallow studies to clinical variables in this patient population. This study highlights the significant incidence of gastrostomy tube dependence and pneumonia in these patients.
Benjamin S Bleier; Marc S Levine; Rosemarie Mick; Stephen E Rubesin; Stephen Z Sack; Kibwei McKinney; Natasha Mirza
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of otology, rhinology, and laryngology     Volume:  116     ISSN:  0003-4894     ISO Abbreviation:  Ann. Otol. Rhinol. Laryngol.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-12-13     Completed Date:  2008-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0407300     Medline TA:  Ann Otol Rhinol Laryngol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  837-41     Citation Subset:  AIM; IM    
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, USA.
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MeSH Terms
Administration, Oral
Aged, 80 and over
Antineoplastic Agents / adverse effects*
Barium Sulfate / administration & dosage,  diagnostic use*
Carcinoma, Squamous Cell / drug therapy,  radiotherapy,  therapy*
Contrast Media / administration & dosage*
Deglutition / drug effects,  radiation effects
Deglutition Disorders / etiology,  physiopathology,  radiography*
Follow-Up Studies
Middle Aged
Oropharyngeal Neoplasms / drug therapy,  radiotherapy,  therapy*
Radiotherapy, Adjuvant / adverse effects
Retrospective Studies
Reg. No./Substance:
0/Antineoplastic Agents; 0/Contrast Media; 7727-43-7/Barium Sulfate

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