Long-term Swallowing Problems After Organ Preservation Therapy With Concomitant Radiation Therapy and Intravenous Hydroxyurea

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Abstract
CANCERS OF the head and neck often have a profound impact on important quality-of-life functions, including swallowing. The successful treatment of these tumors may further impair these functions, and it is not unusual for patients to develop swallowing abnormalities and dysphagia after treatment. Severe dysphagia may be seen after head and neck cancer resection,1-7 surgery with radiotherapy,8,9 or radiotherapy alone,10-12 and may require prolonged enteral alimentation with a gastrostomy tube. Radiation therapy can produce secondary fibrosis of the pharyngeal muscles and soft tissues, with resultant impairment of pharyngeal contraction and laryngeal elevation,11 and inclusion of salivary glands into the radiation field results in xerostomia and hyposalivation, which further impair mastication and the initiation of the swallowing reflex.12