Association of risk factors with patient-reported voice and
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This large Oropharyngeal Cancer (OPC) survivorship cohort study identified many treatment-related factors, including increasing total radiotherapy dose, multimodality induction, and concurrent chemotherapy regimens, and continued smoking, as well as clinical and demographic factors, as risk factors that were associated with moderate to severe voice and speech symptoms.

Voice and speech production are critical physiological functions that affect the quality of life and may deteriorate substantially after oropharyngeal cancer (OPC) treatment. This JAMA study was aimed to identify the risk factors of voice and speech symptoms among long-term survivors of OPC.

This retrospective cohort study with cross-sectional survivorship survey administration includes cancer-free survivors of OPC who were treated curatively. Of 906 survivors of OPC with a median survival duration at the time of the survey of 6 years, patient-rated voice and speech outcomes for 881 were available and analyzed. Among 881 survivors of OPC, 113 reported moderate to severe voice and speech scores.

--Increasing survival time and increasing total radiation dose, Black race, Hispanic ethnicity, current cigarette smoking at the time of the survey, treatment with induction and concurrent chemotherapy, and late and baseline lower cranial neuropathy were risk factors associated with moderate to severe voice and speech symptoms.

--Intensity-modulated radiotherapy split-field regimen was associated with a lower likelihood of moderate to severe voice and speech symptoms.

This large OPC survivorship cohort study identified many treatment-related factors as risk factors that were associated with moderate to severe voice and speech symptoms. The key findings in this study were the protective associations of split-field radiation and that longer-term survivors, and those who continued to smoke had worse voice and speech symptoms.

These findings may inform research and effective targeted clinical voice and speech preservation interventions and smoking cessation interventions to maximize voice and speech function and address quality of life among patients with OPC.

Source: https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2779628
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