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Subjective and perceptive assessment of speech/voice and swallowing function before and after radiation therapy in patients of head-and-neck squamous cell cancer


1 Department of Radiation Oncology, Rural Medical College, PMTPIMS, Loni, Maharashtra, India
2 Department of Radiation Oncology, Rural Medical College and Pravara Rural Hospital, PMTPIMS, Loni, Maharashtra, India
3 Department of Medical Statistics, Rural Medical College and Pravara Rural Hospital, PMTPIMS, Loni, Maharashtra, India

Correspondence Address:
Chaitali Manohar Waghmare,
Department of Radiation Oncology, Rural Medical College and Pravara Rural Hospital, PMTPIMS, Loni, Rahata, Ahmadnagar - 413 736, Maharashtra
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.jcrt_621_21

Aim: To prospectively assess subjective and perceptive speech/voice and swallowing function before and after radiation therapy (RT) in patients of head-and-neck squamous cell cancer (HNSCC). Materials and Methods: The study cohort comprised eligible consecutive HNSCC patients planned for curative RT from April 2018 to July 2018 who consented for the study. Prospective evaluation of speech/voice and swallowing function was done before and after RT. For subjective and perceptive evaluation of speech/voice, speech handicap index (SHI) and Grade, Roughness, Asthenia, Breathiness, and Strain (GRABS) Scale was used, respectively. For subjective and perceptive evaluation of swallowing, M D Anderson Dysphagia Inventory (MDADI) and Performance Status Scale for head and neck (PSSHN) were used, respectively. All patients were taught speech/voice and swallowing exercises before RT. Statistical analysis was performed using SYSTAT version-12 (Cranes software, Bengaluru). Results: The study cohort comprised 30 patients of HNSCC with a median age of 57 years and male-to-female ratio of 4:1. The most common subsite was the oral cavity (43.33%) and a majority (76.66%) presented in the locally advanced stage. Post-RT there was significant improvement in speech/voice function (SHI P = 0.0006, GRABS score P = 0.003). Perceptive assessment of swallowing function by PSSHN showed significant improvement (P = 0.0032), but subjective assessment by MDADI showed no significant (P = 0.394) improvement until the first follow-up. Conclusion: Speech/voice function improved significantly after radiotherapy when combined with rehabilitation exercises. Swallowing function did not improve till the first follow-up. Future studies with the large number of patients and long-term follow-up are needed to document the changes in organ function.


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    -  Aggarwal VV
    -  Waghmare CM
    -  Lolage SN
    -  Pawar HJ
    -  Ravichandran M
    -  Bhanu A
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