Comparison of Swallowing Measures to Patient-Reported Dysphagia Symptoms in Head and Neck Cancer Patients.

Abstract

Abstract Objective Compare subjective patient-reported outcome scores on SWAL-QOL and swallowing safety as measured by Penetration-Aspiration Scale on objective swallowing studies Modified Barium Swallow Study and Fiberoptic Endoscopic Evaluation of Swallowing in Head and Neck Cancer patients. Study Design Retrospective Case Series. Setting A single academic center. Methods Patients completed a SWAL-QOL survey and an objective swallowing study. On the SWAL-QOL, the seven domains of burden, desire, duration, food selection, fear, mental health, and social role were used in scoring to create a Dysphagia Domain Score. Penetration-aspiration scale was used to represent swallowing safety. A Dysphagia Domain Score with an associated Penetration-Aspiration Score constituted a paired data point. Data on primary tumor site, T-stage, and treatment modality was collected. Results A total of 253 paired data points were included in this study. A statistically significant relationship between Penetration-Aspiration Score and Dysphagia Domain Score was observed (p<.05, chi sq). When stratified by tumor site, Penetration-Aspiration Score and Dysphagia Domain Score relationships were significant for oral cavity and larynx subsites. When stratified by T-stage, only T4 tumors had a statistically significant relationship between Penetration-Aspiration Score and Dysphagia Domain Score. Patients were also observed to have less dysphagia symptoms with elevated Penetration-Aspiration Score as they were further removed from treatment. Conclusion Understanding how subjective and objective measures of swallowing function overlap will better inform the assessment of HNC patients. Further research should focus on how to incorporate these complementary assessments to better formulate clinical recommendations. Data Availability Statement The datasets generated and analyzed during the current study are not publicly available due to Protected Health Information which they contain but are available from the corresponding author on reasonable request.