DYSPHAGIA IN POSTIRRADIATION THERAPY HEAD AND NECK-CANCER PATIENTS WITH SALIVARY-GLAND DYSFUNCTON - A PILOT-STUDY

Dysphagia is a common complaint from patients with salivary gland dysf unction (SGD). The purpose of this pilot study was to quantify and com pare dysphagia in patients who had undergone irradiation therapy for h ead and neck cancer (PIT) with SGD. Subjects who had undergone irradia tion therapy for head and neck cancer (PIT) of >60 Gy (n = 8) were sel ected for the study, after meeting the inclusion criteria. An age-sex- matched group of control subjects (n = 8) was selected for comparison. Dysphagia assessments, including videofluoroscopy were performed as p reviously described by Caruso. Dysphagia was quantitated clinically an d videofluoroscopically by measurement of 10-sec. of basal or dry swal lows (DS) as compared to 10-sec, 10 ml. water bolus swallows (WBS) in all subjects. Subjective evaluations were recorded on a calibrated 10- cm visual analog scale. The results indicated a significant difference in the DS as compared to the WBS for the (PIT) SGD group and for both DS and WBS in the (PIT) SGD group as compared to controls: {DS (PIT) = 1.87 +/- 0.14 vs. WBS = 2.5 +/- 0.2; DS (controls) = 3.6 +/- 0.7 vs. WBS = 4.31 +/- 0.7; p < 0.001 by ANCOVA). Videofluoroscopy also yield ed significantly prolonged pharyngeal transit times (PTT) in the (PIT) SGD group as compared to controls: {PIT = 5.7 +/- 0.7 sec.; controls = 3.1 +/- 0.1 sec. p < 0.001). Subjective results indicated a signific antly greater degree of dysphagia symptoms in the (PIT) SGD group (p < 0.001) when compared to the controls. Conclusions from this prelimina ry study indicate clinically significant dysphagia in patients with SG D as a result of irradiation therapy as compared to a control populati on.