Laryngeal penetration and aspiration during swallowing after the treatment of advanced oropharyngeal cancer
Laryngeal penetration and aspiration during swallowing after the treatment of advanced oropharyngeal cancer
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DOI：
10.1001/archotol.131.7.615
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发表时间：
2005-07-01
影响因子：
--
通讯作者：
Martin-Harris, B
中科院分区：
文献类型：
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作者：
Gillespie, MB;Brodsky, MB;Martin-Harris, B
目的：探讨不同治疗组口咽癌患者喉部穿刺和咽吸是否存在差异。设计：对接受联合治疗至少12个月且临床无疾病的III期或IV期口咽鳞状细胞癌患者进行横断面研究。受试者：根据肿瘤部位和肿瘤T分期对潜在受试者进行分层，以实现放化疗组（n = 10）和手术/放疗组（n =11）的相似比较。用于评估吞咽的有效工具包括渗透-吸入量表和md安德森吞咽困难量表。结果：经放化疗的口咽癌患者咽下5 ml （P= 0.02）、10 ml （P= 0.04）和20 ml （P= 0.04）液体钡时气道评分高于手术加放疗患者。此外，根据m.d. Anderson吞咽困难量表，口咽放化疗组的自我感知吞咽能力优于手术放疗组（P= 0.02）。结论：本研究表明，成功完成放化疗而不进行手术挽救的口咽癌患者在吞咽过程中保留了更好的气道保护，吞咽相关的生活质量比接受初次手术和放疗的患者更好。
Objective: To determine whether laryngeal penetration and aspiration in oropharyngeal cancer survivors differ by treatment group.Design: Cross-sectional study of patients with stage III or IV oropharyngeal squamous cell carcinoma who were at least 12 months removed from combined modality therapy and clinically free of disease.Subjects: Potential subjects were stratified by tumor site and tumor T stage to achieve a similar comparison between chemoradiotherapy (n = 10) and surgery/radiotherapy (n =11) groups. Validated instruments used to evaluate swallowing included the Penetration-Aspiration Scale and the M. D. Anderson Dysphagia Inventory.Results: Patients with oropharyngeal cancer treated with chemoradio therapy demonstrated greater airway scores than those treated with surgery and radiotherapy on 5-mL (P=.02), 10-mL (P=.04), and 20-mL (P=.04) liquid barium swallows. Also, the oropharyngeal chemoradiotherapy group had better self-perceived swallowing ability than the surgery-radiotherapy group on the basis of the M. D. Anderson Dysphagia Inventory (P=.02).Conclusion: The present study suggests that patients with oropharyngeal cancer who successfully complete chemoradiotherapy protocols without surgical salvage retain greater airway protection during swallowing and better swallowing-related quality of life than patients treated with primary surgery and radiotherapy.