Comparison of Swallowing Measures to Patient-Reported Dysphagia Symptoms in Head and Neck Cancer Patients.

OBJECTIVE

Head and neck cancer affects patient swallowing function. We set out to examine how objective measures of swallowing compare against subjective patient-reported outcomes in a cohort of head and neck cancer patients.

STUDY

DESIGN

Retrospective analysis of data collected from a large dysphagia HNC registry.

SETTING

Tertiary Academic Cancer Center.

METHODS

Between 2006 and 2019, objective measures of swallowing as scored on Modified Barium Swallow Study or Fiberoptic Endoscopic Evaluation of Swallowing and subjective measures using the SWAL-QOL were collected. Objective measures were scored by the Penetration-Aspiration Score (PAS); subjective measures were assessed by the Dysphagia Domain Score (DDS), collectively forming paired data points. Data on tumor site, T-stage, and treatment modality was collected and evaluated.

RESULTS

A total of 253 paired data points were included in this study. A statistically significant relationship between PAS and DDS was observed across all patients (P < .05, chi sq). When stratified by tumor subsite, PAS and DDS relationships were strongest for oral cavity. When stratified by AJCC T-stage, T4 tumors had the strongest relationship between PAS and DDS. The relationship of PAS and DDS was less congruent the further removed from treatment completion.

CONCLUSION

Objective and subjective measures of swallowing provide complementary evaluations of swallow function. The congruency of assessment varies by T stage and tumor subsite. Physicians and allied health professionals can use this information to better understand the value and limitation of objective and subjective swallowing assessments in evaluating head and neck cancer patients.