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Radiotherapy for cutaneous head and neck cancer and parotid tumours: a prospective investigation of treatment-related acute swallowing and toxicity patterns

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Abstract

Purpose

Reports of acute treatment-related dysphagia and toxicities for patients with parotid tumours or cutaneous head and neck cancer (HNC) are limited. This study aimed to describe the severity and timing of dysphagia and related toxicities experienced during radiotherapy for cutaneous HNC and parotid tumours, to inform the nature of future speech pathology (SP) service models required during treatment.

Methods

Prospective study of 32 patients with parotid tumours and 36 with cutaneous HNC undergoing curative non-surgical management. Dysphagia and acute toxicity data was collected weekly during treatment and at 2, 4 and 12 weeks post-treatment using the Functional Oral Intake Scale, diet descriptors and CTCAE v4.0.

Results

In both groups, minimal treatment toxicities (grades 0–1) were observed. Xerostomia and dysgeusia were the most frequently reported grade 2 toxicities. Only 3% of parotid patients and 6% with cutaneous HNC experienced grade 3 dysphagia. Full or soft texture diets were maintained by > 70% of patients in both groups. Symptoms peaked in the final week of treatment and rapidly improved thereafter. Apart from xerostomia < 10% of patients had any grade 2 toxicity at 12 weeks post-treatment.

Conclusion

Patients in these subgroups of HNC experienced minimal treatment-related toxicity during radiotherapy. As such, the need for supportive symptom management by SP is low. Models that involve interdisciplinary surveillance of symptoms with referral to SP only when required may be best suited for these individuals to ensure issues are identified whilst minimising patient burden created by unnecessary routine SP appointments.

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Acknowledgements

The authors wish to acknowledge the multidisciplinary Head and Neck team at the Royal Brisbane and Women’s Hospital for their support of this project.

Funding

This work received funding from the RBWH Foundation Research Grant, 2014–2015.

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Authors and Affiliations

  1. Royal Brisbane & Women’s Hospital, Metro North Hospital and Health Service, Brisbane, Australia

    Laura B. Moroney, Jennifer Helios, Jane Crombie, Clare L. Burns, Ann-Louise Spurgin, Claire Blake, Lizbeth Kenny, Benjamin Chua & Brett G. M. Hughes

  2. School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia

    Laura B. Moroney, Elizabeth C. Ward, Clare L. Burns & Shu Qi Yeo

  3. Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Australia

    Elizabeth C. Ward

  4. QIMR Berghofer Medical Research Institute, Brisbane, Australia

    Anita Pelecanos

  5. School of Medicine, The University of Queensland, Brisbane, Australia

    Lizbeth Kenny, Benjamin Chua & Brett G. M. Hughes

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  1. Laura B. Moroney
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  2. Jennifer Helios
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  3. Elizabeth C. Ward
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  4. Jane Crombie
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Correspondence to Laura B. Moroney.

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Ethical clearance was provided by the local Human Research Ethics Committee (approval number: HREC/13/QRBW/444).

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Moroney, L.B., Helios, J., Ward, E.C. et al. Radiotherapy for cutaneous head and neck cancer and parotid tumours: a prospective investigation of treatment-related acute swallowing and toxicity patterns. Support Care Cancer 27, 573–581 (2019). https://doi.org/10.1007/s00520-018-4352-5

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