FEEDING TUBE, TRACHEOSTOMY DEPENDENCE AND MOBILITY OF LARYNX IN POST-CHEMORADIATION PATIENTS AT A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Regimens combining chemotherapy and radiotherapy, aimed at organ preservation, are being increasingly used in the primary treatment of laryngeal and hypopharyngeal cancers. Meta-analysis reveals improved survival rates in advanced laryngeal and hypopharyngeal cancers. However, the main drawback of such regimen is morbidity. Aim: To evaluate dependence on feeding tube and tracheostomy and to assess the mobility of larynx in advanced cancers of larynx and hypopharynx treated with chemoradiation. Methods: Prospective analysis of 89 patients with locally advanced laryngeal and hypopharyngeal cancers treated with concurrent chemoradiation was carried out. Functional outcomes with respect to dependence rates on feeding tube and tracheostomy were analyzed. Return of mobility of larynx at 6 months and 1 year respectively, was observed and assessed independently by two observers. A third opinion was sought in case of disparity. Results: At the end of 6 months, 37% patients were dependent on feeding tube, 12.4% on tracheostomy. Larynx mobility improvement was seen in 48.3% of the patients. Conclusion: Functional organ preservation is the key focus of contemporary Head and Neck Cancer management. In our study, feeding tube dependence was observed in more than one third of the patients and subjective improvement in larynx mobility in nearly half of the patients.