The 10-item Eating Assessment Tool (EAT-10), Functional Oral Intake Scale (FOIS), and pain were correlative for the evaluation of swallowing functionality and ingestion status among patients undergoing chemoradiotherapy (CRT) for head and neck cancer. These findings, from a prospective, single-center observational study were published in Supportive Care in Cancer.

To clarify the correlations between symptoms for patients treated with definitive CRT for oropharyngeal and hypopharyngeal cancers, researchers evaluated 38 patients using the EAT-10 questionnaire, FOIS for ingestion status, scale of Fiberoptic Endoscopic Evaluation of Swallowing (FEES), and Penetration-Aspiration Scale (PAS) on videofluoroscopic (VF) evaluation. The patients were assessed between 2004 and 2006 at 5 time points.

At baseline 100% of patients ate normally. During treatment, the FOIS status significantly (P <.001) decreased. FOIS status improved after treatment but remained significantly lower (P <.001) when compared with baseline and only 65.8% of patients reported eating normally.

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Oral dryness and dysgeusia worsened during CRT (P <.001, P <.05, respectively) and remained significantly worse at 3 months. Mucositis and analgesic were significantly worse during CRT (P <.001) but returned to near normal levels. EAT-10 scores worsened significantly at the start of treatment (P <.001) and slowly improved.

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EAT-10 and pain were highly correlated with FOIS at 2 time points each. VF and FEES were not correlated.

The major limitation of this study is that some patients refused evaluations due to nausea or fatigue, introducing selection bias.

The study authors concluded that some evaluations (VF) were unnecessary due to high correlations, and that EAT-10 and pain reflected changes in FOIS scores among patients with head and neck cancer.


Ishii R, Kato K, Ohkoshi A, et al. Simultaneous evaluation of symptoms, swallowing functions, and patient-reported swallowing difficulties and their correlations with ingestion status during definitive chemoradiotherapy for oropharyngeal and hypopharyngeal cancer [published online June 16, 2020]. Support Care Cancer. doi: 10.1007/s00520-020-05570-2