Page 32 - Functional impairment and cues for rehabilitation of head and neck cancer patients -

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Chapter 2
Available data
Of the 150 participants offered surgery, 102 (68%), 87 (58%), and 83 (55%) had EORTC- QLQ-H&N35 data available at baseline, 4- and 12-month follow-up respectively. Of the 150 participants offered RT, EORTC-QLQ-H&N35 data was available for 114 (76%), 93 (62%), and 80 (53%) participants respectively. Characteristics of participants with data available at 12-month follow-up (Appendix 4) were comparable to those of the total group, except the participants who completed the questionnaire lived in more affluent areas. Of the 163 participants with data available at 12-month follow-up, 138 (85%) also had data available at 4-month follow-up.
Self-reported swallowing outcomes – ‘not at all’ and ‘a little’ versus ‘quite a bit’ and ‘very much’
Self-reported swallowing outcomes are presented in Appendix 5. Figure 1 illustrates the RRs per outcome measure at 4- and 12-month follow-up. At 4-month follow-up, more participants offered RT reported problems swallowing, especially with solid foods than those offered surgery (55% vs. 35%, minimally adjusted RR 1.6; 95% CI 1.0–2.5, p = .051, adjusted RR 1.3; 95% CI 0.8–2.0, p = .249). At 12-month follow-up, these proportions decreased to 35% and 23% for RT and surgery participants respectively (minimally adjusted 1.3; 95% CI 0.7–2.3, p = .362 and adjusted RR 1.3; 95% CI 0.8–2.3, p = .277).
Self-reported swallowing outcomes - ‘not at all’ versus ‘a little’, ‘quite a bit’ and ‘very much’
Appendix 6 shows self-reported swallowing outcomes (and secondary outcomes) with no including ‘not at all’ (instead of ‘not at all’ and ‘a little’) and yes including ‘a little’, ‘quite a bit’, and ‘very much’ (instead of only ‘quite a bit’ and ‘very much’). The difference in RRs are presented in Figure 2. At 4-month follow-up, differences between surgery and RT participants are similar. At 12-month follow-up, however not consistent, differences between surgery and RT participants are more prominent when the cut-off is between ‘not at all’ and ‘a little’. At 12-month follow- up the differences between surgery and RT participants with problems swallowing all consistencies and solids appeared were smaller when more severe symptoms are considered, while the differences with problems swallowing liquids and purees were greater.
Differences between RT and surgery regarding swallowing problems were more prominent when only participants were included who received their intended single-modality treatment (Appendix 7). Participants who received surgery with adjuvant (C)RT were more likely to report swallowing problems than participants who received surgery only. Swallowing outcomes of participants receiving surgery with (C)RT and those who received RT were comparable.