Long- term functional and survival outcomes after induction chemotherapy and risk- based definitive therapy for locally advanced squamous cell carcinoma of the head and neck

BackgroundThe purpose of this study was to evaluate long-term outcomes after induction chemotherapy followed by risk-based local therapy for locally-advanced squamous cell carcinoma of the head and neck (SCCHN). MethodsForty-seven patients (stage IV; N2b) were enrolled in a phase II trial. Baseline and 24-month functional measures included modified barium swallow (MBS) studies, oropharyngeal swallow efficiency (OPSE), and the MD Anderson Dysphagia Inventory (MDADI). Functional status was assessed at 5 years. ResultsFive-year overall survival (OS) was 89% (95% confidence interval [CI], 81% to 99%). A nonsignificant 13% average reduction in swallowing efficiency (OPSE) was observed at 24 months relative to baseline (p = .191). MDADI scores approximated baseline at 24 months. Among 42 long-term survivors (median, 5.9 years), 3 patients (7.1%) had chronic dysphagia. The rate of final gastrostomy dependence was 4.8% (2 of 42). ConclusionSequential chemoradiotherapy achieved favorable outcomes among patients with locally advanced SCCHN, mainly of oropharyngeal origin. MBS and MDADI scores found modest swallowing deterioration at 2 years, and chronic aspiration was uncommon in long-term survivors. (c) 2013 Wiley Periodicals, Inc. Head Neck36: 474-480, 2014