Brian

Interesting abstract. I agree that swallowing difficult is primary radiation based, but just as dysphagia cannot be tied to a PEG alone, this study of 50 people with 50 or 60 GY does not appear to have segregated those with a PEG and those without. It certainly does not refute the PEG dependency/ swallowing memory loss/atrophy theories/concerns that RO's like mine and many others have when they encourage their patients to go without a PEG if they can.
Of course I'm biased since I still think it significant that after my first 72 GY in a field that also encompassed the constrictor muscles, I bounced right back with no dysphagia.
We disagreed on this issue when I first joined OCF, and until and unless there are some relevant studies on dysphagia with and without a PEG tube with similar radiation fields, I think we continue to do so.
That said, there is no doubt at all that my second round of radiation bringing me up to 97 GY did mean the constrictor damage was permanent and had nothing at all to do with my PEG. The first thing my SLP said to me when I went for swallowing therapy was "why are you here with that much radiation and especially where you had it?" she focused on speech. I had to go back to my CCC to find another SLP who did VitalStim who was willing to try but she also felt that it was a very long shot.
Both SLP's made the same point as the journal and your post. It's the radiation that is the primary culprit.
Charm