External HNL largely resolves by 12 months post-CRT, but internal HNL persists. Worse patient-reported swallowing outcomes were associated with a higher severity of external HNL ( p=0.001) and more diffuse internal HNL ( p=0.002). More severe penetration/aspiration and increased diet modification were associated with higher severities of external HNL ( p=0.006 and p=0.031, respectively) and internal HNL ( p<0.001 and p=0.007, respectively), and more diffuse internal HNL ( p=0.043 and p=0.001, respectively). In contrast, moderate/severe internal HNL was prevalent at 3 months (96%), 6 months (84%) and at 12 months (65%). External HNL was prevalent at 3 months (71%), improved by 6 months (58%) and largely resolved by 12 months (10%). Associations between HNL and swallowing were examined using multivariable regression models. Swallowing was assessed via clinical, instrumental and patient-reported measures. Internal HNL was rated using Patterson’s Radiotherapy Oedema Rating Scale. External HNL was assessed using the Assessment of Lymphoedema of the Head and Neck and the MD Anderson Cancer Centre Lymphoedema Rating Scale. ![]() ![]() Using a prospective longitudinal cohort study, external/internal HNL and swallowing were examined in 33 participants at 3, 6 and 12 months post-CRT. The aim of the study was to examine the following: (a) the trajectory of external and internal head and neck lymphoedema (HNL) in patients with head and neck cancer (HNC) up to 12 months post-chemoradiotherapy (CRT) and (b) the relationship between HNL and swallowing function.
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