Assessing The Severity of Oropharyngeal Dysphagia and its Relation to Quality of Life Status in Head and Neck Cancer Patients After Undergoing Chemoradiotherapy in DR Sardjito Public Hospital, Yogyakarta, Indonesia: A Cross Sectional Prospective Study

Authors

  • Anisa Haqul Khoiria Universitas Aisyiyah
  • Agus Surono Universitas Gadjah Mada
  • Camelia Herdini Universitas Gadjah Mada

DOI:

https://doi.org/10.46799/adv.v4i8.622

Keywords:

dysphagia, quality of life, head and neck cancer, gugging and swallowing screening, swallowing quality of life

Abstract

Head and neck cancer treatment frequently causes oropharyngeal dysphagia, which may impair nutritional status, psychological well-being, social functioning, and overall quality of life. This study aimed to assess dysphagia severity and swallowing-related quality of life, compare changes in these outcomes during early follow-up, and determine the relationship between dysphagia severity and quality of life among patients after chemoradiotherapy. A prospective observational study was conducted among 60 patients with head and neck cancer at the ENT Outpatient Clinic of Dr. Sardjito General Hospital, Yogyakarta. Oropharyngeal dysphagia was evaluated using the Gugging Swallowing Screen, while quality of life was measured using the Indonesian version of the Swallowing Quality of Life questionnaire during the first and 12th weeks after treatment. Data were analyzed using the Kruskal–Wallis, Gamma correlation, and Friedman tests. Dysphagia severity was significantly associated with quality of life at the first week (r = 0.729; p < 0.001) and the 12th week (r = 0.827; p < 0.001). However, dysphagia severity (p = 0.782) and quality of life (p = 1.000) did not change significantly between assessments. Delayed swallowing was the predominant symptom, whereas burden and eating desire were the most affected quality-of-life domains. In conclusion, persistent dysphagia was strongly associated with poorer quality of life, emphasizing the need for early screening, multidisciplinary management, and continuous swallowing rehabilitation.

References

Ackerstaff, A. H., Tan, I. B., Rasch, C. R. N., et al. (2002). Quality-of-life assessment after supradose selective intra-arterial cisplatin and concomitant radiation (RADPLAT) for inoperable stage IV head and neck squamous cell carcinoma. Archives of Otolaryngology–Head & Neck Surgery, 128(10), 1185. https://doi.org/10.1001/archotol.128.10.1185

Carmignani, I., Locatello, L. G., Desideri, I., et al. (2018). Analysis of dysphagia in advanced-stage head-and-neck cancer patients: Impact on quality of life and development of a preventive swallowing treatment. European Archives of Oto-Rhino-Laryngology, 275(8), 2159–2167. https://doi.org/10.1007/s00405-018-5054-9

Denaro, N., Merlano, M. C., & Russi, E. G. (2013). Dysphagia in head and neck cancer patients: Pretreatment evaluation, predictive factors, and assessment during radio-chemotherapy, recommendations. Clinical and Experimental Otorhinolaryngology, 6(3), 117. https://doi.org/10.3342/ceo.2013.6.3.117

Gustafsson, B., & Tibbling, L. (1991). Dysphagia, an unrecognized handicap. Dysphagia, 6(4), 193–199. https://doi.org/10.1007/BF02493525

Heijnen, B. J., Böhringer, S., & Speyer, R. (2020). Prediction of aspiration in dysphagia using logistic regression: Oral intake and self-evaluation. European Archives of Oto-Rhino-Laryngology, 277(1), 197–205. https://doi.org/10.1007/s00405-019-05687-z

Hunter, M., Kellett, J., Toohey, K., D’Cunha, N. M., Isbel, S., & Naumovski, N. (2020). Toxicities caused by head and neck cancer treatments and their influence on the development of malnutrition: Review of the literature. European Journal of Investigation in Health, Psychology and Education, 10(4), 935–949. https://doi.org/10.3390/ejihpe10040066

Ihara, Y., Kato, H., Tashimo, Y., et al. (2022). Changes in oral function, swallowing function, and quality of life in patients with head and neck cancer: A prospective cohort study. BMC Oral Health, 22(1), 293. https://doi.org/10.1186/s12903-022-02329-5

King, S. N., Dunlap, N. E., Tennant, P. A., & Pitts, T. (2016). Pathophysiology of radiation-induced dysphagia in head and neck cancer. Dysphagia, 31(3), 339–351. https://doi.org/10.1007/s00455-016-9710-1

Kusuma, L. T., Antono, D., & Muyassaroh, M. (2021). Hubungan lama waktu pasca kemoradiasi dengan derajat disfagia orofaringeal pada karsinoma nasofaring. Medica Hospital: Journal of Clinical Medicine, 8(1), 7–14. https://doi.org/10.36408/mhjcm.v8i1.400

Machtay, M., Moughan, J., Trotti, A., et al. (2008). Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: An RTOG analysis. Bodine Journal, 1(1). https://doi.org/10.29046/TBJ.001.1.006

Martin-Harris, B., & McFarland, D. (2013). Principles of deglutition (pp. 25–34). https://doi.org/10.1007/978-1-4614-3794-9_3

Menzies, I. E. P. (1970). Psychosocial aspects of eating. Journal of Psychosomatic Research, 14(3), 223–227. https://doi.org/10.1016/0022-3999(70)90047-4

Murcott, A. (1982). The cultural significance of food and eating. Proceedings of the Nutrition Society, 41(2), 203–210. https://doi.org/10.1079/PNS19820031

Nguyen, N. P., Frank, C., Moltz, C. C., et al. (2005). Impact of dysphagia on quality of life after treatment of head-and-neck cancer. International Journal of Radiation Oncology, Biology, Physics, 61(3), 772–778. https://doi.org/10.1016/j.ijrobp.2004.06.017

Paleri, V., Roe, J. W. G., Strojan, P., et al. (2014). Strategies to reduce long-term postchemoradiation dysphagia in patients with head and neck cancer: An evidence-based review. Head & Neck, 36(3), 431–443. https://doi.org/10.1002/hed.23251

Pauloski, B. R., Logemann, J. A., Rademaker, A. W., et al. (1993). Speech and swallowing function after anterior tongue and floor of mouth resection with distal flap reconstruction. Journal of Speech, Language, and Hearing Research, 36(2), 267–276. https://doi.org/10.1044/jshr.3602.267

Sabirin, M. S. M., Permana, A. D., & Soeseno, B. (2016). Epidemiologi penderita tumor ganas kepala leher di Departemen Telinga Hidung Tenggorokan–Kepala Leher Rumah Sakit Dr. Hasan Sadikin Bandung, Indonesia, periode 2010–2014. Tunas Medika: Jurnal Kedokteran & Kesehatan, 3(1).

Saputro, S. H., & Susworo, R. (n.d.). Pencegahan dan tatalaksana disfagia akibat radiasi pada kanker kepala leher.

Silveira, M., Dedivitis, R., Queija, D., & Nascimento, P. (2014). Quality of life in swallowing disorders after nonsurgical treatment for head and neck cancer. International Archives of Otorhinolaryngology, 19(1), 46–54. https://doi.org/10.1055/s-0034-1395790

Stringer, S. (1999). Managing dysphagia in palliative care. Professional Nurse, 14(7), 489–492.

Thankappan, K., Iyer, S., & Menon, J. R. (2020). Dysphagia management in head and neck cancers: A manual and atlas. Revista Brasileira de Cancerologia, 66(4). https://doi.org/10.32635/2176-9745.RBC.2020v66n4.1235

To’Bungan, N., Hamidatul A’liyah, S., Wijayanti, N., & Fachiroh, J. (2015). Epidemiologi, stadium, dan derajat diferensiasi kanker kepala dan leher. Biogenesis: Jurnal Ilmiah Biologi, 3(1), 47–52. https://doi.org/10.24252/bio.v3i1.566

Tsai, C. J., Jackson, A., Setton, J., et al. (2017). Modeling dose response for late dysphagia in patients with head and neck cancer in the modern era of definitive chemoradiation. JCO Clinical and Cancer Informatics, (1), 1–7. https://doi.org/10.1200/CCI.17.00070

Yifru, T. A., Kisa, S., Dinegde, N. G., & Atnafu, N. T. (2021). Dysphagia and its impact on the quality of life of head and neck cancer patients: Institution-based cross-sectional study. BMC Research Notes, 14(1), 11. https://doi.org/10.1186/s13104-020-05440-4

Downloads

Published

2026-08-28

How to Cite

Khoiria, A. H., Surono, A. ., & Herdini, C. . (2026). Assessing The Severity of Oropharyngeal Dysphagia and its Relation to Quality of Life Status in Head and Neck Cancer Patients After Undergoing Chemoradiotherapy in DR Sardjito Public Hospital, Yogyakarta, Indonesia: A Cross Sectional Prospective Study. Advances In Social Humanities Research, 4(8), 711–723. https://doi.org/10.46799/adv.v4i8.622