Self‐Reported Dysphagia in Head and Neck Cancer Survivors From Diagnosis to Twelve Months Post Treatment and Predictors for Moderate to Severe Long‐Term Dysphagia

BACKGROUND: Dysphagia is a common complication of head and neck cancer (HNC) and its treatment. This study examined swallowing-related quality of life from diagnosis to 12 months after treatment, compared swallowing outcomes across tumor sites and treatment modalities, and identified predictors of moderate-to-severe dysphagia. METHODS: The M. D. Anderson Dysphagia Inventory (MDADI) was completed by 445 patients receiving curatively intended HNC treatment pre-treatment and at 3-, 6-, and 12-months post-treatment. RESULTS: Swallowing-related quality of life worsened during treatment, the poorest scores at 3 months post-treatment; 21.6% reported moderate-to-severe dysphagia, decreasing to 12.5% at 12 months. Risk factors for dysphagia at 12 months included stage IV disease, surgery combined with (chemo)radiotherapy, smoking cessation within 12 months, and pre-treatment sick leave. Patients with cervical carcinoma of unknown primary (CCUP) had the poorest outcomes. CONCLUSIONS: Swallowing function declined during treatment. Patients receiving surgery combined with (chemo)radiotherapy and patients with CCUP are at increased risk of long-term dysphagia and require closer follow-up.