Dysphagia after chemo-radiation for nasopharyngeal cancer: A scoping review

Objective: Nasopharyngeal cancer (NPC) has distinct characteristics regarding its global prevalence, initial presentation, management and patient outcomes compared to other subtypes of head and neck cancer (HNC). The mainstay of NPC treatment is chemo-radiation (C/RT) and while dysphagia is a known...

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Autores principales:	Raymond Fong, Elizabeth C. Ward, Anna F. Rumbach
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2020
Materias:	Nasopharyngeal carcinoma Swallowing Dysphagia Deglutition Scoping review Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/721f0a3d74b94709b5a06c65d8153347
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spelling	oai:doaj.org-article:721f0a3d74b94709b5a06c65d81533472021-12-02T13:40:44ZDysphagia after chemo-radiation for nasopharyngeal cancer: A scoping review2095-881110.1016/j.wjorl.2020.02.005https://doaj.org/article/721f0a3d74b94709b5a06c65d81533472020-03-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881120300287https://doaj.org/toc/2095-8811Objective: Nasopharyngeal cancer (NPC) has distinct characteristics regarding its global prevalence, initial presentation, management and patient outcomes compared to other subtypes of head and neck cancer (HNC). The mainstay of NPC treatment is chemo-radiation (C/RT) and while dysphagia is a known early and late toxicity of C/RT treatment, the nature of dysphagia post NPC treatment has had limited investigation. The objective of this review is to summarise the existing evidence regarding dysphagia following NPC to inform the future research agenda for this population. Dysphagia incidence, characteristic deficits observed across the phases of swallowing, efficacy of current dysphagia interventions, and effect on quality of life will be explored. Data sources: Databases including MEDLINE, CINAHL, Embase, Scopus and Web of Science were included. Methods: A scoping review was conducted according to PRISMA-ScR guidelines. Two independent reviewers screened selected full text articles. Results: Of the initial 2495 articles found, 28 articles were included. Reports of penetration and aspiration varied widely (0%–91.6%), with high rates of silent aspiration identified in 2 studies (42%, 66%). Oral, pharyngeal and upper esophageal phase impairments were reported. Of these, upper esophageal stasis and multiple pharyngeal stage deficits were most prevalent. The pharyngeal constrictors were found to have a significant dose–effect relationship and shielding to the anterior neck field was effective to preserve swallowing function. Six treatment studies were identified with limited evidence supporting the use of neuromuscular electrical stimulation, dilatation and swallowing exercises. Quality of life was adversely affected. Conclusions: Dysphagia is a prevalent early and late problem post NPC treatment, with impairments across all phases of the swallow. Studies on preventing dysphagia and treatment efficacy remain limited. More systematic study of the nature of dysphagia and the efficacy of treatment in this population is warranted.Raymond FongElizabeth C. WardAnna F. RumbachKeAi Communications Co., Ltd.articleNasopharyngeal carcinomaSwallowingDysphagiaDeglutitionScoping reviewOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 6, Iss 1, Pp 10-24 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Nasopharyngeal carcinoma Swallowing Dysphagia Deglutition Scoping review Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Nasopharyngeal carcinoma Swallowing Dysphagia Deglutition Scoping review Otorhinolaryngology RF1-547 Surgery RD1-811 Raymond Fong Elizabeth C. Ward Anna F. Rumbach Dysphagia after chemo-radiation for nasopharyngeal cancer: A scoping review
description	Objective: Nasopharyngeal cancer (NPC) has distinct characteristics regarding its global prevalence, initial presentation, management and patient outcomes compared to other subtypes of head and neck cancer (HNC). The mainstay of NPC treatment is chemo-radiation (C/RT) and while dysphagia is a known early and late toxicity of C/RT treatment, the nature of dysphagia post NPC treatment has had limited investigation. The objective of this review is to summarise the existing evidence regarding dysphagia following NPC to inform the future research agenda for this population. Dysphagia incidence, characteristic deficits observed across the phases of swallowing, efficacy of current dysphagia interventions, and effect on quality of life will be explored. Data sources: Databases including MEDLINE, CINAHL, Embase, Scopus and Web of Science were included. Methods: A scoping review was conducted according to PRISMA-ScR guidelines. Two independent reviewers screened selected full text articles. Results: Of the initial 2495 articles found, 28 articles were included. Reports of penetration and aspiration varied widely (0%–91.6%), with high rates of silent aspiration identified in 2 studies (42%, 66%). Oral, pharyngeal and upper esophageal phase impairments were reported. Of these, upper esophageal stasis and multiple pharyngeal stage deficits were most prevalent. The pharyngeal constrictors were found to have a significant dose–effect relationship and shielding to the anterior neck field was effective to preserve swallowing function. Six treatment studies were identified with limited evidence supporting the use of neuromuscular electrical stimulation, dilatation and swallowing exercises. Quality of life was adversely affected. Conclusions: Dysphagia is a prevalent early and late problem post NPC treatment, with impairments across all phases of the swallow. Studies on preventing dysphagia and treatment efficacy remain limited. More systematic study of the nature of dysphagia and the efficacy of treatment in this population is warranted.
format	article
author	Raymond Fong Elizabeth C. Ward Anna F. Rumbach
author_facet	Raymond Fong Elizabeth C. Ward Anna F. Rumbach
author_sort	Raymond Fong
title	Dysphagia after chemo-radiation for nasopharyngeal cancer: A scoping review
title_short	Dysphagia after chemo-radiation for nasopharyngeal cancer: A scoping review
title_full	Dysphagia after chemo-radiation for nasopharyngeal cancer: A scoping review
title_fullStr	Dysphagia after chemo-radiation for nasopharyngeal cancer: A scoping review
title_full_unstemmed	Dysphagia after chemo-radiation for nasopharyngeal cancer: A scoping review
title_sort	dysphagia after chemo-radiation for nasopharyngeal cancer: a scoping review
publisher	KeAi Communications Co., Ltd.
publishDate	2020
url	https://doaj.org/article/721f0a3d74b94709b5a06c65d8153347
work_keys_str_mv	AT raymondfong dysphagiaafterchemoradiationfornasopharyngealcancerascopingreview AT elizabethcward dysphagiaafterchemoradiationfornasopharyngealcancerascopingreview AT annafrumbach dysphagiaafterchemoradiationfornasopharyngealcancerascopingreview
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Dysphagia after chemo-radiation for nasopharyngeal cancer: A scoping review

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