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Crit Rev Oncol Hematol. 2015 Nov;96(2):372-84. doi: 10.1016/j.critrevonc.2015.06.005. Epub 2015 Jun 19.

Dysphagia in head and neck cancer patients treated with radiotherapy and systemic therapies: Literature review and consensus.

Author information

1
Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy. Electronic address: antonio.schindler@unimi.it.
2
Medical Oncology Department AO. S. Croce e Carle - Cuneo, Italy. Electronic address: nerinadenaro@gmail.com.
3
Department of Radiation Oncology, A.O. S. Croce e Carle Cuneo, Italy. Electronic address: elviorussi@gmail.com.
4
Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy. Electronic address: nicole.pizzorni@virgilio.it.
5
Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: paolo.bossi@istitutotumori.mi.it.
6
Radiation Oncology Department, Ospedale di Circolo di Busto Arsizio, Italy. Electronic address: anna.merlotti@virgilio.it.
7
Department of Audiology-Phoniatrics, Università degli Studi di Torino, Italy. Electronic address: spadola.massimo@alice.it.
8
Medical Oncology Unit, Ospedale U. Parini, Viale Ginevra 3, 11100 Aosta, Italy. Electronic address: gnumico@ausl.vda.it.
9
Department of Radiation Oncology, Treviso Regional Hospital, Treviso, Italy. Electronic address: agava@ulss.tv.it.
10
Radio-Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: Ester.Orlandi@istitutotumori.mi.it.
11
Radiation Oncology Department, Isola Tiberina Fatebenefratelli Hospital, Rome, Italy. Electronic address: Fabriori@libero.it.
12
Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: michela.buglione@med.unibs.it.
13
Advanced Radiotherapy Center, European Institute of Oncology, Milan, Italy. Electronic address: daniela.alterio@ieo.it.
14
Radio-Oncology Department, IRCCS San Martino-IST, Largo R Benzi 10, 16132 Genoa, Italy. Electronic address: almalina.bacigalupo@hsanmartino.it.
15
Department of Radiotherapy University "La Sapienza", Rome, Italy. Electronic address: vitaliana.desanctis@uniroma1.it.
16
Department of Radiotherapy, Ospedale Santa Maria della Misericordia, Rovigo, Italy. Electronic address: pavanato.giovanni@azisanrovigo.it.
17
Supportive Care in Cancer Unit, IRCCS Foundation National Cancer Institute, Milan, Italy. Electronic address: Carla.Ripamonti@istitutotumori.mi.it.
18
Medical Oncology Department AO. S. Croce e Carle - Cuneo, Italy. Electronic address: mcmerlano@gmail.com.
19
Radiation Oncology Department, Ospedale di Circolo di Busto Arsizio, Italy. Electronic address: Lisa.Licitra@istitutotumori.mi.it.
20
Department of Radiotherapy, National Cancer Institute Regina Elena, Rome, Italy. Electronic address: gsangui1@gmail.com.
21
Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: j.a.langendijk@umcg.nl.
22
Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Nashville, TN, USA. Electronic address: barbara.murphy@vanderbilt.edu.

Abstract

BACKGROUND:

Head and neck cancer (HNC) and its therapy are associated with acute and late swallowing dysfunction. Consensus guidelines regarding evaluation and management are lacking. To address this gap, a multidisciplinary team of experts (oncologists, practitioners, deglutologists, etc.) met in Milan 17-18 February 2013 with the aim of reaching a consensus on the management of swallowing difficulties in HNC patients treated with radiotherapy with or without systemic therapies (such as chemotherapy and targeted agents). The consensus was focused particularly on those statements with limited evidence. The results of the literature review and the statements that obtained a consensus are reported and discussed in this paper.

MATERIALS AND METHODS:

The Delphi Appropriateness Method was used for this consensus. External expert reviewers then evaluated the conclusions carefully according to their area of expertise.

RESULTS:

This paper contains 6 clusters of statements about the management of swallowing problems in radio-treated HNC patients and a review of the recent literature on these topics.

CONCLUSIONS:

Dysphagia assessment and its management are difficult and require a multi-team cooperation (ENT specialists, radiation and medical oncologists, deglutologists, etc.).

KEYWORDS:

Chemotherapy; Deglutition; Dysphagia; Head and neck cancer; Radiation oncology; Radiotherapy; Swallowing dysfunction

[Indexed for MEDLINE]

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