Functional and quality of life outcomes after partial glossectomy: a multi-institutional longitudinal study of the head and neck research network.
Functional and quality of life outcomes after partial glossectomy: a multi-institutional longitudinal study of the head and neck research network.
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DOI：
10.1186/s40463-017-0234-y
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发表时间：
2017-09-04
期刊：
影响因子：
--
通讯作者：
Head and Neck Research Network
中科院分区：
文献类型：
--
作者：
Dzioba A;Aalto D;Papadopoulos-Nydam G;Seikaly H;Rieger J;Wolfaardt J;Osswald M;Harris JR;O'Connell DA;Lazarus C;Urken M;Likhterov I;Chai RL;Rauscher E;Buchbinder D;Okay D;Happonen RP;Kinnunen I;Irjala H;Soukka T;Laine J;Head and Neck Research Network
虽然积极的口腔癌治疗可能会优化生存，但往往会导致言语和吞咽功能和生活质量的下降。这项探索性研究调查了舌癌患者在术后第一年内，在接受或不接受辅助(化疗)放射治疗的初次手术后，他们的交流功能、吞咽能力和生活质量的恢复情况。在三个机构(阿尔伯塔大学医院、西奈山以色列医学中心和图尔库大学医院)接受口腔癌症治疗的患者接受了患者报告结果评估[言语障碍指数(SHI)]、吞咽[M.D.安德森吞咽困难问卷(MDADI)]和生活质量[欧洲癌症研究和治疗组织生活质量问卷头颈部模块(EORTC-H&N35)]。分别于术前、术后1个月、6个月和12个月完成结果测量。117例接受舌部分切除重建术的患者参加了这项研究。结果显示，术后6个月吞咽功能(MDADI和EORTC-H&N35分量表)与术后6个月比较差异无统计学意义，言语功能(SHI分量表)与术后1年比较差异无统计学意义。大多数生活质量领域(EORTC-H&N35子量表)在术后1年恢复到基线水平，而口干和唾液粘稠的困难仍然存在。在这项研究中，明确了辅助(化疗)放射治疗随着时间的推移对口干评分产生负面影响的时间趋势，而化疗对MDADI吞咽和EORTC-H&N35吞咽、进食和张口分量表的负面独立影响被发现。评估时间影响患者报告的言语、吞咽和生活质量结果，而治疗(按时间)仅对吞咽和生活质量结果产生影响。本研究的结果将有助于指导临床护理，并将有助于对口腔癌手术和辅助治疗的预期短期和长期功能和生活质量结果的咨询。本文的在线版本(10.1186/s40463-0170234-y)包含补充材料，授权用户可以使用。
While aggressive treatment for oral cancer may optimize survival, decrements in speech and swallowing function and quality of life often result. This exploratory study investigated how patients recover their communicative function, swallowing ability, and quality of life after primary surgery [with or without adjuvant (chemo)radiation therapy] for tongue cancer over the course of the first year post-operation. Patients treated for oral cancer at three institutions (University of Alberta Hospital, Mount Sinai Beth Israel Medical Center, and Turku University Hospital) were administered patient-reported outcomes assessing speech [Speech Handicap Index (SHI)], swallowing [(M.D. Anderson Dysphagia Inventory (MDADI)] and quality of life [European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC-H&N35)]. Outcome measures were completed pre-operatively and at 1-, 6-, and 12-months post-operatively. One hundred and seventeen patients undergoing partial glossectomy with reconstruction participated in this study. Results indicated no significant differences in swallowing function (MDADI and EORTC-H&N35 subscales) between baseline and 6 months post-surgery and no significant differences in speech function (SHI subscales) between baseline and 1 year post-surgery. Most quality of life domains (EORTC-H&N35 subscales) returned to baseline levels by 1 year post-operation, while difficulties with dry mouth and sticky saliva persisted. A clear time trend of adjuvant (chemo)radiation therapy negatively affecting dry mouth scores over time was identified in this study, while negative independent effects of chemoradiation on MDADI swallowing, and EORTC-H&N35 swallowing, eating, and opening mouth subscales were found. Assessment time influenced patient-reported speech, swallowing, and quality of life outcomes, while treatment (by time) effects were found for only swallowing and quality of life outcomes. Results of the present study will help guide clinical care and will be useful for patient counseling on expected short and long-term functional and quality of life outcomes of surgical and adjuvant treatment for oral cavity cancer. The online version of this article (10.1186/s40463-017-0234-y) contains supplementary material, which is available to authorized users.
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DOI：
10.1002/hed.20735
发表时间：
2008-04-01
影响因子：
2.9
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发表时间：
2010-01-01
影响因子：
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