Bhethanabotla Rohith M, Gulati Arushi, Khalsa Inderpreet K, Evans Cara, Perrin Claire E, Lappin James J, Kidane Joseph, Crosby Tyler W, Chan Jason W, Yom Sue S, Young VyVy N, Rosen Clark A, Schneider Sarah L, Ha Patrick K, Boscardin W John, Laus Joey, Ryan William R, Ma Yue
Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA.
University of California San Francisco School of Medicine, San Francisco, California, USA.
Head Neck. 2025 Oct;47(10):2650-2660. doi: 10.1002/hed.28166. Epub 2025 May 5.
This study aimed to evaluate swallow outcomes in head and neck cancer (HNC) survivors enrolled in a long-term dysphagia surveillance protocol following curative intent radiotherapy (RT).
We conducted a retrospective review of videofluoroscopic swallow studies from 2015 to 2023 in HNC patients treated with RT. Swallow kinematics and function were assessed at baseline, 0-1, 1-2, 2-5, and 5+ years post-RT. Logistic regression models assessed kinematic deviations beyond 2SD from normative and dichotomized outcomes.
Among 638 patients with 1167 VFSS, 14.6% were 2 years post-RT, primarily oral cavity (29.6%) and oropharyngeal (46.7%) cancers treated with adjuvant (chemo) RT (53.3%). At 2 years, 51.3% exhibited abnormal hyolaryngeal movement, 27.5% had pharyngeal contraction abnormalities, and 9.0% had impaired pharyngoesophageal opening. Unsafe swallow was seen in 51.6% with moderate-to-profound dysphagia in 45%.
Dysphagia surveillance revealed significant swallowing impairments in HNC survivors, with unsafe swallowing prevalent in over half of cases 2 years post-RT.
本研究旨在评估接受根治性放疗（RT）后纳入长期吞咽困难监测方案的头颈癌（HNC）幸存者的吞咽结果。
我们对2015年至2023年接受RT治疗的HNC患者的视频荧光吞咽造影研究进行了回顾性分析。在放疗后的基线、0至1年、1至2年、2至5年和5年以上评估吞咽运动学和功能。逻辑回归模型评估了与正常情况相比超过2个标准差的运动学偏差以及二分法结果。
在638例患者的1167次视频荧光吞咽造影检查中，14.6%的患者处于放疗后2年，主要为接受辅助（化疗）放疗（53.3%）的口腔癌（29.6%）和口咽癌（46.7%）。在2年时，51.3%的患者表现出喉下咽运动异常，27.5%的患者有咽部收缩异常，9.0%的患者有咽食管开口受损。51.6%的患者存在不安全吞咽，45%的患者有中度至重度吞咽困难。
吞咽困难监测显示，HNC幸存者存在明显的吞咽障碍，放疗后2年超过半数病例存在不安全吞咽。
