Swallowing function after chemoradiation for advanced oropharyngeal cancer
ABSTRACT Advanced-stage oropharyngeal cancer may be treated either surgically or nonsurgically. We reported previously functional outcomes after surgical resection with free-tissue transfer. In the present study, we evaluated swallowing function after combined chemoradiation for oropharyngeal cancer.
Retrospective review of 30 patients treated at a tertiary academic center for Stage III/IV oropharyngeal cancer with sequential or concurrent chemoradiation from 1994 to 2003.
Inclusion criteria were met by 27 of 30 (90%) patients. Most patients had base of tongue lesions (67%) and Stage IV disease (93%). Gastrostomy was carried out in 22 (82%) patients either before or during treatment. Three months after chemoradiation, 33% (9/27) were consuming all nutrition orally, 22% (6 of 27) were NPO, and 45% (12 of 27) had some oral intake but still required tube feeds. One year after treatment, 53% (10 of 19) had an exclusively oral diet whereas 47% still required tube feeds including 1 patient (5%) who was NPO. In patients without recurrence and follow-up length >1 year, 69% (9 of 13) were consuming all nutrition orally whereas 31% still required gastrostomy tube (G-tube) support. A higher rate of G-tube dependence was observed in patients treated for base of tongue lesions vs tonsil lesions (67% vs 25%, P = 0.049, chi(2) analysis).
At this institution, the short-term (3-4 months) rate of G-tube dependence was similar after surgical and non-surgical treatment of oropharyngeal cancer. One year after chemoradiation, 31% of patients without recurrence still required tube feeds.
These results suggest that organ-preservation protocols do not reduce the prevalence of chronic dysphagia and G-tube dependence after management of oropharyngeal cancer. EBM rating: C-4.
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Proceedings of The Nutrition Society 01/2011; 70(OCE5). DOI:10.1017/S0029665111003685 · 4.94 Impact Factor
- "It is estimated that 10 % of long-term head and neck cancer survivors require permanent enteral nutrition (Machtay et al. 2002). Significant functional impairment after chemoradiation has also been documented (Shilley et al. 2006). However, there is limited information in the literature regarding the long term side effects of radiation therapy to the head and neck area. "
Conference Paper: SDR-based digital IF for multi-band W-CDMA transceiver[Show abstract] [Hide abstract]
ABSTRACT: This paper discusses the implementation of multi-band digital IF for W-CDMA transceiver. The implemented module in hardware is majorly composed of wideband ADC/DAC and FPGA, and the software is coded by VHDL. At transmitter, digital filter is constructed via cascading a series of decimation and interpolation filters, and in order to upconvert the multi-band baseband channels simultaneously, two-stage digital complex quadrature modulation (DCQM) is utilized. Relevant numerically controlled oscillator (NCO) to up- and down-conversion is designed in a form of LUT having samples associated with 1/4 period of sampled sinusoidal. At receiver, to avoid the usage of SAW filter, the high performance digital filter is implemented subject to satisfying band rejection ratio prescribed in blocker and adjacent channel specification. This paper provides the performance of the implemented digital IF module via showing the results measured from the measurement instruments. Moreover, computer simulations are conducted simultaneously to confirm its validity.Information, Communications and Signal Processing, 2003 and the Fourth Pacific Rim Conference on Multimedia. Proceedings of the 2003 Joint Conference of the Fourth International Conference on; 01/2004
- Journal of the American Dietetic Association 04/2007; 107(3):412-5. DOI:10.1016/j.jada.2007.01.029 · 3.92 Impact Factor