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Is Radiation or Chemoradiation Best for Oropharyngeal Cancer Patients

ved and equally returned to an oral diet by one year post-treatment. Patients who did not have a PFG placed during treatment were more likely to return to a regular diet post-treatment. About half of both patient groups received swallowing evaluations. More CRT patients than RT patients had abnormal swallow studies. Severity of patient swallowing complaints did not correlate to their level of swallowing dysfunction.

The past decade has seen a rise in the use of chemoradiation to treat Stage IV oropharyngeal squamous cell carcinoma. For the small primary disease stage III and IV oropharyngeal cancer, there appears to be similar survival with radiation alone versus chemoradiation. Because of this, assessment of long-term quality of life will best determine the optimal treatment for these patients.

The use of chemoradiation to treat low volume stage IV oropharyngeal cancer resulted in a trend towards more swallowing toxicity and PFG placement during and initially after therapy. However, there appears to be no difference in the long-term feeding tube dependence and severe swallowing dysfunction between these patient groups. Further prospective multimodal analysis is needed to fully describe the swallowing and diet differences between these two patient populations.

While this study seems to demonstrate that chemoradiation does lead to worsening swallowing function during the treatment phase (indicated by increased need for inter-treatment feeding tube placement), there does not seem to be any difference in the return to swallowing function within the year (indicated by removal of PFG).

Due to the retrospective nature of this study, there are limitations in the evaluation of swallowing function. Without modified barium swallows and formal speech pathology evaluations on every patient, it is impossible to assess the detailed effects of treatment on swallowing function. To better assess this, a prospective study utilizing
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