Effect of induction chemotherapy on speech and swallowing function in patients with oral tongue cancer

Abstract

Background: Swallowing physiology, diet, and patient-reported outcomes were evaluated after induction chemotherapy for oral tongue cancer.

Methods: Fifteen of 23 patients enrolled in a phase II clinical trial of induction chemotherapy followed by surgical resection for oral tongue cancer underwent instrumental and perceptual analysis of speech and swallowing. Oropharyngeal swallow efficiency (OPSE) was calculated. Patient-reported outcomes were collected. We compared pre- and postchemotherapy results.

Results: OPSE scores were not significantly different (p > .05) after induction chemotherapy; however, patient-reported swallowing and diet levels were significantly higher (p < .001 and p = .015, respectively). Diet levels improved from soft-chewable to full diet in most patients. Speech intelligibility did not change (p = .328).

Conclusion: It appears that induction chemotherapy has a negligible effect on speech and swallowing physiology but may provide symptomatic improvement of pain and swallowing after treatment. Further investigations are needed to corroborate these findings.

Figures

Figure 1. Treatment schema

Abbreviations: mg, milligrams: AUC, area under curve: m2, meter squared: q, every: d, day: RT, radiation therapy: CBDCA, carboplatin

Figure 2

OPSE for each bolus consistency before and after induction chemotherapy.

Figure 3

MDADI responses and PSS-HN scores for patient-reported diet levels.

Figure 4

Speech intelligibility ratings at baseline and after induction chemotherapy.