Swallowing-related quality of life after head and neck cancer treatment
Swallowing-related quality of life after head and neck cancer treatment
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DOI：
10.1097/00005537-200408000-00008
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发表时间：
2004-08-01
期刊：
影响因子：
2.6
通讯作者：
Martin-Harris, B
中科院分区：
文献类型：
--
作者：
Gillespie, MB;Brodsky, MB;Martin-Harris, B
目的：确定治疗方式对头颈癌治疗后吞咽结果的作用，并确定治疗后吞咽困难的潜在危险因素。研究设计：对 III 期或 IV 期口咽、喉或下咽鳞状细胞癌治疗后 12 个月或更长时间没有疾病证据的患者进行横断面调查。方法：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 (n = 18) 和手术/放疗 (n = 22) 组之间的平衡比较。结果测量包括吞咽困难危险因素调查、MD 安德森吞咽困难量表 (MDADI) 和简式 36 (SF-36)。结果：接受口咽部初次放化疗的患者在 MDADI 情绪 (P = .03) 和功能 (P = .02) 分量表上的得分明显高于接受手术后放疗的患者。放化疗组和手术/放疗组之间的喉部和下咽部初级检查没有显着差异。治疗后吞咽困难的其他危险因素包括长期（>2 周）不经口 (NPO) 状态 (P = .002) 和低 SF-36 心理健康子量表评分 (P = .002)。结论：该研究表明，对于口咽原发性食管癌患者，放化疗可能比手术/放疗提供更好的吞咽结果。心理健康状况不佳且饲管时间较长的患者出现长期吞咽困难的风险可能更高。
Objectives: To determine the role of treatment modality in swallowing outcome after head and neck cancer treatment and to identify potential risk factors for posttreatment dysphagia. Study Design: Cross-sectional survey of patients with no evidence of disease 12 months or more after the treatment of a stage III or IV squamous cell carcinoma of the oropharynx, larynx, or hypopharynx. Methods: Potential subjects were stratified by tumor site and tumor T-stage to achieve a balanced comparison between chemoradiation (n = 18) and surgery/radiation (n = 22) groups. Outcome measures included a dysphagia risk factor survey, the MD Anderson Dysphagia Inventory (MDADI), and the Short-Form 36 (SF-36). Results: Patients who received chemoradiation for oropharyngeal primaries demonstrated significantly better scores on the emotional (P = .03) and functional (P = .02) subscales of the MDADI than did patients who underwent surgery followed by radiation. There were no significant differences between chemoradiation and surgery/radiation groups for laryngeal and hypopharyngeal primaries. Additional risk factors for posttreatment dysphagia include prolonged (>2 weeks) nothing by mouth (NPO) status (P = .002) and low SF-36 Mental Health Subscale score (P = .002). Conclusion: The study suggests that chemoradiation may provide superior swallowing outcome to surgery/radiation in patients with oropharyngeal primary. Patients with depressed mental health and prolonged feeding tubes may be at higher risk of long-term dysphagia.