Dysphagia in Head and Neck Cancer With Radiation

Swallowing dysfunction is a common and debilitating symptom in head and neck cancer patients, affecting approximately 60-75% during the disease course, primarily due to tumor destruction, postoperative complications, and side effects of radiotherapy and chemotherapy. Combined chemoradiotherapy exacerbates adverse effects, such as mucositis, odynophagia, taste alterations, xerostomia, nausea, vomiting, and fatigue, which can result in dehydration, significant weight loss, and detrimental impacts on nutritional status, functionality, and quality of life. Limited research exists on the effects of radiation and chemoradiation doses on swallowing muscles, quality of life, and nutritional changes in these patients. This study aims to evaluate the impact of radiation doses on swallowing muscles and quality of life in head and neck cancer patients undergoing chemoradiotherapy while identifying malnutrition risk in this population. Non-surgical patients receiving radiotherapy as the primary treatment will be recruited, with swallowing, muscle, and nutritional assessments conducted before treatment, three months after treatment, and within one year post-treatment.

Inclusion criteria

• Patients scheduled to undergo radiotherapy or concurrent chemoradiotherapy ;
• Aged between 18 and 80 years;
• Able to perform self-care independently (ECOG ≤ 2);
• All patients provide written informed consent.

Exclusion criteria

• Patients scheduled to undergo surgical treatment;
• Patients with neuromuscular diseases, such as stroke or Parkinson's disease;
• Patients with other diseases or complications, including heart disease classified as NYHA functional class ≥ 2 with thrombotic conditions, or lung disease classified as Hugh-Jones grade ≥ 4;
• Patients with psychological disorders that may affect their ability to provide informed consent or comply with the study protocol;
• Patients who do not consent to undergo high-resolution impedance manometry.