Swallowing and Communication Outcomes Post Chemoradiotherapy for Low-Risk Human Papillomavirus (HPV)-Associated Oropharyngeal Squamous Cell Carcinoma: A Substudy of TROG 12.01.

Abstract

This substudy aimed to assess swallow and communication outcomes in patients undergoing treatment for low-risk human papillomavirus-associated oropharyngeal squamous cell carcinoma. Videofluoroscopy swallowing studies (VFSS) were conducted pre-treatment, 12 and 24 months post treatment, alongside quality of life and symptom severity measures for patients receiving 70Gy radiotherapy with either weekly cisplatin or cetuximab. Of 126 patients who underwent VFSS, there were no differences in swallowing outcomes between cisplatin and cetuximab arms. VFSS outcomes were worst at 12 months and improved by 24 months, with low aspiration rates and high swallow function at all timepoints. Older age, higher T-stage, and base of tongue tumors (versus tonsil) were associated with poorer swallowing. Clinician-and patient-reported speech and voice problems were minimal. Swallowing was safe and efficient, and communication highly intelligible at 24 months post treatment. Both 'objective' and patient-reported measures are important to understand the impact of new treatment approaches on swallowing-related outcomes.