Swallowing Outcomes in Oropharyngeal Carcinoma Patients Post Radiotherapy Combined with Concurrent Chemotherapy

Oropharyngeal squamous cell carcinoma (OPSCC), increasingly linked to Human Papilloma Virus (HPV) in younger populations, is commonly treated with concurrent chemoradiotherapy (chemoRT). A prospective observational study evaluated swallowing outcomes in 20 histologically confirmed OPSCC patients pre- and 3 months post-chemoRT using objective tools - Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Penetration-Aspiration Scale (PAS), Yale Pharyngeal Residue Severity Rating Scale (YPRS), and Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) and subjective tools − 100 mL Water Swallow Test, FOIS, and the MD Anderson Dysphagia Inventory (MDADI). FOIS and MDADI scores declined significantly post-treatment (p = 0.05 and p = 0.001) suggesting deteriorated swallowing function and quality of life. No significant changes were observed in PAS, YPRS, DIGEST, or 100 mL test. Tobacco chewing correlated with poorer FOIS scores (p =.022); smoking and alcohol showed no significant impact. T3 tumors caused greater MDADI decline vs. T2 (p =.003). Although objective swallowing remained mostly stable, chemoRT negatively impacted perceived swallowing quality. Routine post-treatment swallowing assessments and rehabilitation are recommended.