Oropharyngeal dysphagia and cachexia: Intertwined in head and neck cancer

Anna C H Willemsen; Walmari Pilz; Ann Hoeben; Frank J P Hoebers; Annemie M W J Schols; Laura W J Baijens

doi:10.1002/hed.27288

Oropharyngeal dysphagia and cachexia: Intertwined in head and neck cancer

Anna C H Willemsen^*, Walmari Pilz, Ann Hoeben, Frank J P Hoebers, Annemie M W J Schols, Laura W J Baijens

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: This study aims to investigate the relationship between cancer cachexia and oropharyngeal dysphagia (OD) in patients with head and neck cancer (HNC) prior to chemoradiotherapy or bioradiotherapy (CRT/BRT).

METHODS: A prospective cohort study with patients with HNC undergoing CRT/BRT (2018-2021) was conducted. Body composition and skeletal muscle function were evaluated using bioelectrical impedance analysis, handgrip strength, and the short physical performance battery (SPPB). The M. D. Anderson Dysphagia Inventory (MDADI), Eating Assessment Tool (EAT)-10 questionnaire, and patient characteristics were collected. A standardized videofluoroscopic swallowing study was offered to patients.

RESULTS: Sixty-six patients were included. Twenty-six patients scored EAT-10 ≥ 3 and seventeen were cachectic. ACE-27 score >1, cachexia, abnormal SPPB-derived repeated chair-stand test, lower MDADI scores, and higher overall stage grouping showed potential predictive value (p ≤ 0.10) for EAT-10 ≥ 3. Using multivariable regression analysis, only cachexia remained a significant predictor of EAT-10 ≥ 3 (HR 9.000 [95%CI 2.483-32.619], p = 0.001).

CONCLUSION: Cachexia independently predicted the presence of patient-reported OD.

Original language	English
Pages (from-to)	783-797
Number of pages	15
Journal	Head and Neck-Journal for the Sciences and Specialties of the Head and Neck
Volume	45
Issue number	4
Early online date	30 Dec 2022
DOIs	https://doi.org/10.1002/hed.27288
Publication status	Published - Apr 2023

Keywords

Cancer cachexia
Chemoradiotherapy
Head and neck cancer
Oropharyngeal dysphagia
Videofluoroscopic swallowing study

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10.1002/hed.27288Licence: CC BY-NC-ND

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title = "Oropharyngeal dysphagia and cachexia: Intertwined in head and neck cancer",

abstract = "BACKGROUND: This study aims to investigate the relationship between cancer cachexia and oropharyngeal dysphagia (OD) in patients with head and neck cancer (HNC) prior to chemoradiotherapy or bioradiotherapy (CRT/BRT).METHODS: A prospective cohort study with patients with HNC undergoing CRT/BRT (2018-2021) was conducted. Body composition and skeletal muscle function were evaluated using bioelectrical impedance analysis, handgrip strength, and the short physical performance battery (SPPB). The M. D. Anderson Dysphagia Inventory (MDADI), Eating Assessment Tool (EAT)-10 questionnaire, and patient characteristics were collected. A standardized videofluoroscopic swallowing study was offered to patients.RESULTS: Sixty-six patients were included. Twenty-six patients scored EAT-10 ≥ 3 and seventeen were cachectic. ACE-27 score >1, cachexia, abnormal SPPB-derived repeated chair-stand test, lower MDADI scores, and higher overall stage grouping showed potential predictive value (p ≤ 0.10) for EAT-10 ≥ 3. Using multivariable regression analysis, only cachexia remained a significant predictor of EAT-10 ≥ 3 (HR 9.000 [95%CI 2.483-32.619], p = 0.001).CONCLUSION: Cachexia independently predicted the presence of patient-reported OD.",

keywords = "Cancer cachexia, Chemoradiotherapy, Head and neck cancer, Oropharyngeal dysphagia, Videofluoroscopic swallowing study",

author = "Willemsen, {Anna C H} and Walmari Pilz and Ann Hoeben and Hoebers, {Frank J P} and Schols, {Annemie M W J} and Baijens, {Laura W J}",

note = "Funding Information: Anna C. H. Willemsen was funded by the Nutrim Graduate Programme, 2018 laureate. Publisher Copyright: {\textcopyright} 2022 The Authors. Head & Neck published by Wiley Periodicals LLC.",

year = "2023",

month = apr,

doi = "10.1002/hed.27288",

language = "English",

volume = "45",

pages = "783--797",

journal = "Head and Neck-Journal for the Sciences and Specialties of the Head and Neck",

issn = "1043-3074",

publisher = "John Wiley & Sons Inc.",

number = "4",

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T1 - Oropharyngeal dysphagia and cachexia

T2 - Intertwined in head and neck cancer

AU - Willemsen, Anna C H

AU - Pilz, Walmari

AU - Hoeben, Ann

AU - Hoebers, Frank J P

AU - Schols, Annemie M W J

AU - Baijens, Laura W J

PY - 2023/4

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N2 - BACKGROUND: This study aims to investigate the relationship between cancer cachexia and oropharyngeal dysphagia (OD) in patients with head and neck cancer (HNC) prior to chemoradiotherapy or bioradiotherapy (CRT/BRT).METHODS: A prospective cohort study with patients with HNC undergoing CRT/BRT (2018-2021) was conducted. Body composition and skeletal muscle function were evaluated using bioelectrical impedance analysis, handgrip strength, and the short physical performance battery (SPPB). The M. D. Anderson Dysphagia Inventory (MDADI), Eating Assessment Tool (EAT)-10 questionnaire, and patient characteristics were collected. A standardized videofluoroscopic swallowing study was offered to patients.RESULTS: Sixty-six patients were included. Twenty-six patients scored EAT-10 ≥ 3 and seventeen were cachectic. ACE-27 score >1, cachexia, abnormal SPPB-derived repeated chair-stand test, lower MDADI scores, and higher overall stage grouping showed potential predictive value (p ≤ 0.10) for EAT-10 ≥ 3. Using multivariable regression analysis, only cachexia remained a significant predictor of EAT-10 ≥ 3 (HR 9.000 [95%CI 2.483-32.619], p = 0.001).CONCLUSION: Cachexia independently predicted the presence of patient-reported OD.

AB - BACKGROUND: This study aims to investigate the relationship between cancer cachexia and oropharyngeal dysphagia (OD) in patients with head and neck cancer (HNC) prior to chemoradiotherapy or bioradiotherapy (CRT/BRT).METHODS: A prospective cohort study with patients with HNC undergoing CRT/BRT (2018-2021) was conducted. Body composition and skeletal muscle function were evaluated using bioelectrical impedance analysis, handgrip strength, and the short physical performance battery (SPPB). The M. D. Anderson Dysphagia Inventory (MDADI), Eating Assessment Tool (EAT)-10 questionnaire, and patient characteristics were collected. A standardized videofluoroscopic swallowing study was offered to patients.RESULTS: Sixty-six patients were included. Twenty-six patients scored EAT-10 ≥ 3 and seventeen were cachectic. ACE-27 score >1, cachexia, abnormal SPPB-derived repeated chair-stand test, lower MDADI scores, and higher overall stage grouping showed potential predictive value (p ≤ 0.10) for EAT-10 ≥ 3. Using multivariable regression analysis, only cachexia remained a significant predictor of EAT-10 ≥ 3 (HR 9.000 [95%CI 2.483-32.619], p = 0.001).CONCLUSION: Cachexia independently predicted the presence of patient-reported OD.

KW - Cancer cachexia

KW - Chemoradiotherapy

KW - Head and neck cancer

KW - Oropharyngeal dysphagia

KW - Videofluoroscopic swallowing study

U2 - 10.1002/hed.27288

DO - 10.1002/hed.27288

M3 - Article

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SN - 1043-3074

VL - 45

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JO - Head and Neck-Journal for the Sciences and Specialties of the Head and Neck

JF - Head and Neck-Journal for the Sciences and Specialties of the Head and Neck

IS - 4

ER -

Oropharyngeal dysphagia and cachexia: Intertwined in head and neck cancer

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Keywords

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