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OA05 - Increasing the Impact of Nursing and Allied Health Professional Interventions in Lung Cancer Care (ID 130)
- Event: WCLC 2019
- Type: Oral Session
- Track: Nursing and Allied Professionals
- Presentations: 1
- Now Available
OA05.01 - A Prospective Study of Swallowing and Voice Outcomes After Treatment for Small-Cell Lung Cancer (Now Available) (ID 2225)
15:15 - 16:45 | Presenting Author(s): Jacqui Frowen
Dysphagia (difficulty swallowing) and dysphonia (impaired voice) have been identified in patients with lung cancer as being a significant problem. However, research to date has been limited in its measurement and it remains unknown which patients experience dysphagia or dysphonia, and what the impact of these problems are to the patient. The purpose of this study was to identify the prevalence and nature of dysphagia and dysphonia in patients with limited stage SCLC.Method
A prospective cohort pilot study was conducted on 12 patients receiving chemoradiotherapy for limited-stage SCLC. Data collection included: videofluoroscopy swallowing studies (VFSS) to investigate swallowing physiology, aspiration risk and oesophageal motility disorders; limitations to oral intake; patient-reported swallowing problems; and patient-reported voice problems. Data were collected before treatment and again at one, three and six months post-treatment.Result
No patient was observed to aspirate, and the pharyngeal swallow was safe and functional in all cases. Three patients exhibited oesophageal motility disorders before treatment, while three more exhibited these disorders at the post-treatment assessments. Oral intake was most compromised one month post-treatment; at this time one patient was tube dependent, two required a single consistency diet and two had a diet requiring special preparation. At all other time-points patients were managing a normal or near-normal diet. Despite an absence of oropharyngeal dysphagia observed on VFSS, three patients reported moderate or severe swallowing difficulties one month post-treatment; these self-reported difficulties were no more than mild at follow-up assessments. Three additional patients reported the onset of moderate or severe swallowing difficulties at three and six months post-treatment. Patients who reported swallowing difficulties at one month post-treatment had all received a mean radiation dose to the oesophagus of ≥15.7Gy and a maximum dose to the oesophagus of ≥42Gy, however these relationships were no longer apparent at three and six months post-treatment. Patient-reported voice difficulties were variable, with the worst scores being reported at one month post-treatment for a subset of patients, who continued to report problems across voice-related physical, functional and emotional domains at three and six months post-treatment.Conclusion
This is the first time that detailed swallowing and voice outcomes have been reported in patients with SCLC. Although patient numbers are small, this study identified discordance between observed swallowing function and patient-reported problems, which may have significant clinical implications for the management of patients with SCLC, as well as identify important issues for future research.
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