Dysphagia After Radiotherapy for Head and Neck Cancer: Etiology, Clinical Presentation, and Efficacy of Current Treatments After radiation therapy (RT) or chemoradiation (CRT) therapy for head and neck cancer, some patients develop significant swallowing problems. This complication is thought to be a result of radiation induced damage and chronic alteration of tissues whereby the body reacts to the radiation by producing fibrosis. In some persons, this ... Article
Article  |   June 01, 2010
Dysphagia After Radiotherapy for Head and Neck Cancer: Etiology, Clinical Presentation, and Efficacy of Current Treatments
Author Affiliations & Notes
  • Susan E. Langmore
    Speech and Hearing Sciences, Department of Otorhinolaryngology, Boston Medical Center, Boston, MA
  • Gintas P. Krisciunas
    Speech and Hearing Sciences, Department of Otorhinolaryngology, Boston Medical Center, Boston, MA
Article Information
Swallowing, Dysphagia & Feeding Disorders / Special Populations / Articles
Article   |   June 01, 2010
Dysphagia After Radiotherapy for Head and Neck Cancer: Etiology, Clinical Presentation, and Efficacy of Current Treatments
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), June 2010, Vol. 19, 32-38. doi:10.1044/sasd19.2.32
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), June 2010, Vol. 19, 32-38. doi:10.1044/sasd19.2.32

After radiation therapy (RT) or chemoradiation (CRT) therapy for head and neck cancer, some patients develop significant swallowing problems. This complication is thought to be a result of radiation induced damage and chronic alteration of tissues whereby the body reacts to the radiation by producing fibrosis. In some persons, this healing process seems to go awry, thus causing excess fibrosis and dysphagia. The major problem faced by patients with dysphagia is stiffness of tissue and underlying muscle weakness, causing reduced bolus clearance; hence, food is much more problematic than liquids. In fact, aspiration is rare unless the dysphagia is severe.

While compensatory treatment for dysphagia post C/RT is helpful, it is not rehabilitative. More permanent rehabilitative approaches use exercise regiments along with stretching. Massage, lymphedema therapy and electrical stimulation are sensory based or externally based treatments that also are employed, but less frequently. Unfortunately, the efficacy of most treatment approaches is limited, and randomized clinical trials urgently are needed to guide clinicians who work with this population.

Acknowledgment
This article was supported in part by National Institutes of Health grant 5R01CA120950-03.
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