Trends in Swallowing Outcomes Following Deintensified Treatment in Selected p16+ Oropharyngeal Carcinoma.

OBJECTIVE

Identify trends in swallowing outcomes in p16+ oropharyngeal squamous cell carcinoma following neoadjuvant chemotherapy+surgery (NAC+S) versus neoadjuvant chemotherapy+surgery+radiation (NAC+S+R).

STUDY DESIGN

Cohort study.

SETTING

Single academic institution.

METHODS

Swallowing outcome was measured using a validated questionnaire, MD Anderson Dysphagia Inventory (MDADI). MDADI scores were compared between NAC+S and NAC+S+R groups in short-term (<1 year), middle-term (1-3 years), and long-term (>3 years). Clinical factors associated with MDADI scores were explored using a linear mixed model. Statistical significance was established at  < .05.

RESULTS

Sixty-seven patients met the inclusion criteria and were divided into 2 groups: NAC+S (57 [85.1%]) and NAC+S+R (10 [14.9%]). All patients had improved MDADI scores in the middle-term compared to short-term (NAC+S: score increase = 3.43,  = .002; NAC+S+R: score increase = 11.18,  = .044), long-term compared to short-term (NAC+S: score increase = 6.97,  < .001; NAC+S+R: score increase = 20.35,  < .001), and long-term compared to middle-term (NAC+S: score increase = 3.54,  = .043; NAC+S+R: score increase = 9.18,  = .026). NAC+S patients had better MDADI scores than NAC+S+R patients at short-term (83.80 vs 71.26,  = .001). There was no significant difference in swallowing function in the middle-term or long-term.

CONCLUSION

Regardless of treatment type, swallowing will likely be improved in the middle-term and long-term compared to the short-term. Patients treated with NAC+S+R will have worse short-term swallowing function. However, in the middle-term and long-term, there is no significant difference in swallowing function between patients treated with NAC+S and NAC+S+R.