Transoral laser microsurgery ± adjuvant therapy versus chemoradiotherapy for stage III and IVA oropharyngeal squamous cell carcinoma: Preliminary comparison of early swallowing outcomes.

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Transoral laser microsurgery ± adjuvant therapy versus chemoradiotherapy for stage III and IVA oropharyngeal squamous cell carcinoma: Preliminary comparison of early swallowing outcomes.

Head Neck. 2015 Oct;37(10):1488-94

Authors: O'Hara J, Cosway B, Muirhead C, Leonard N, Goff D, Patterson J

Abstract
BACKGROUND: Observational data suggests transoral surgery may offer benefit in swallowing over chemoradiotherapy.
METHODS: In this preliminary, non-randomized study, patients with stage III and IVA oropharyngeal carcinoma treated with transoral laser microsurgery (TLM) were assessed pretreatment and 3 months after treatment using the MD Anderson Dysphagia Inventory (MDADI), the Performance Status Scale (PSS), and a timed Water Swallow Test (WST). Comparisons were made with a historical chemoradiotherapy (CRT) cohort.
RESULTS: Based on patients with measurements at both times, the decrease in score between baseline and 3 months was greater for CRT patients (n = 26-28) than for TLM (n = 20-21) patients for each of MDADI, PSS, and WST. A repeated measures analysis that looked at all 3 scores simultaneously and allowed for missing values gave mostly similar results (except for MDADI).
CONCLUSION: TLM was associated with good early swallowing outcomes at 3 months and may offer a benefit over CRT. The results should be viewed as preliminary data, providing useful reference for any proposed controlled trial.

PMID: 24891273 [PubMed - indexed for MEDLINE]

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