Cho AH, Lewis E, Nathan C. COSM Presentation, 2010.
OBJECTIVES: To determine if reflux is increased in laryngo-hypopharyngeal cancer patients who have had radiation (XRT) ± chemotherapy compared to non-radiated patients.
RESULTS: The majority of patients had laryngeal cancer (83%). All patients who were treated with XRT ± chemotherapy primarily had significant reflux as indicated by considerably higher Ryan scores (mean of 547.42 ± 303.59 upright) compared to those who did not have XRT ± chemotherapy (mean of 37.42 ± 63.70 upright) (p=0.0004). Two of the three patients treated primarily with XRT ± chemotherapy had reflux in upright and supine positions, while one patient only had reflux in the upright position. Four of the nine non-radiated patients had reflux only in the upright position, and no one had reflux in the supine position. The mean supine Ryan scores of patients treated with XRT ± chemotherapy was 27.88 ± 35.41 compared to 2.88 ± 1.23 in nonradiated patients (p=0.0398).
CONCLUSION: This preliminary study demonstrated that XRT ± chemotherapy caused significant increase in Ryan reflux score compared to non-radiated patients. Given that XRT causes xerostomia and the absence of the neutralizing effect of bicarbonate in the saliva, we believe that XRT causes a significant increase in LPR. Although this is a pilot study and the numbers are still small, the results are striking and there is no objective data in literature linking XRT to reflux at this time.