Abstract

Objectives/Case description: A 48 year old male presented with 6-month history of odynophagia and xerostomia, which began during chemotherapy (cetuximab) and radiation therapy (66 Gray in 33 fractions) for treatment of clinical stage T1N1M0 squamous cell carcinoma of his tongue. Odynophagia was described as aching pain at the base of his tongue that felt like his throat was swollen, and was worse with swallowing. He also reported xerostomia, with associated dysphagia and impaired taste. The patient had failed pilocarpine, Biotene rinse, and speech therapy. Physical examination revealed dry oral mucous membranes and skin hyperpigmentation on the neck, consistent with radiation therapy. The musculoskeletal and neurological exam of the head, neck, and upper extremities were otherwise unremarkable.

Methods: He received weekly 20-minute sessions of acupuncture (using combination of manual, auricular, and electroacupuncture) for 10 sessions. He completed a self-report questionnaire asking about the percentage improvement of his symptoms of pain, dry mouth, difficulty swallowing, taste impairment, insomnia, and anxiety at each session.

Results: He reported resolution of odynophagia after 4 acupuncture sessions, with the most dramatic improvement after session #2 (50%) and session #3 (90%). He reported gradual improvement of xerostomia, with 30-40% improvement, over 10 acupuncture sessions. Gradual improvement over 10 acupuncture sessions was noted in symptoms associated with xerostomia, such as ability to swallow (25-30% improvement), and sense of taste (25-30% improvement).

Discussion: Odynophagia and xerostomia are common complications after chemoradiation in oropharyngeal cancer, and can be difficult to manage. This case report found that acupuncture was effective in treating odynophagia and xerostomia after chemoradiation in oropharyngeal cancer.

Keywords: Acupuncture, deglutition disorders, oropharyngeal neoplasms, xerostomia