EFFECT OF SURGERY ON SPEECH AND SWALLOWING IN PATIENTS WITH RECURRENT DISEASE

手术对复发性疾病患者言语和吞咽的影响

• 批准号: 6236742
• 负责人: BARBARA R. PAULOSKI
• 金额: $ 25.31万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-04-01 至 1998-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6236742
• 关键词: audiotape; behavioral /social science research tag; cancer rehabilitation /care; clinical research; combination cancer therapy; eating; employment /unemployment; fluoroscopy; human subject; human therapy evaluation; minimal residual disease; neoplasm /cancer chemotherapy; neoplasm /cancer radiation therapy; neoplasm /cancer remission /regression; neoplasm /cancer surgery; nutrition related tag; oral pharyngeal neoplasm; postoperative state; radiography; socializations; speech; swallowing

Changes in patterns of care over the past ten years have resulted in the treatment of many oral and oropharyngeal cancer patients with primary radiotherapy plus/minus chemotherapy who would have previously received surgical intervention. It is expected that a number of these patients will present with recurrent or residual disease for which surgery will be required for cancer control. These patients may face significant functional impairment in speech and swallow functions after secondary or "salvage" surgery. This study will examine the functional impairments and recovery of function experienced by this patient group over a 12 month period after surgical intervention. Functional status also will be compared with that of head and neck cancer patients treated with surgery and with that of patients treated with primary radiotherapy plus/minus chemotherapy. Accruals will include 50 patients with planned anterior oral cavity resections (e.g., oral tongue, anterior or lateral floor of mouth) and 50 patients with planned posterior oral cavity resections (e.g., tongue base, tonsil, lateral pharyngeal wall). This study is designed to: 1) determine the degree of impairment in speech and swallowing function in oral or oropharyngeal cancer patients with recurrent or residual disease after primary treatment with radiotherapy plus/minus chemotherapy who have been treated surgically; and determine how speech and swallowing function, and employment, socialization, and eating status change over time 1, 3, 6, and 12 months after surgery as compared to presurgical function; 2) determine the relative contributions of prior radiotherapy plus/minus chemotherapy and current surgical intervention to the degree of impairment of speech and swallow functions; determine whether the time to recurrence impacts on postsurgical speech and swallowing function; determine whether there are functional differences between patients with recurrent versus residual disease both before and after surgery; 3) compare the speech and swallowing function of surgically-treated oral or oropharyngeal cancer patients with recurrent or residual disease with that of patients with similar resections/reconstructions who have had surgery or surgery with post- operative radiotherapy only; 4) compare the speech and swallowing function of surgically-treated oral or oropharyngeal cancer patients with recurrent or residual disease with that of patients with similar cancers who receive radiotherapy plus/minus chemotherapy. Achievement of these objectives will identify the functional deficits and degree of severity experienced by surgically-treated oral or oropharyngeal cancer patients with recurrent or residual disease after primary treatment with radiotherapy plus/minus chemotherapy, and provide information on the relative functional status of patients treated with various modalities.

过去十年护理模式的变化导致 治疗了许多原发性口腔癌和口咽癌患者 以前接受过放疗加/减化疗的人 手术干预。 预计这些患者中有一定数量 将出现复发或残留疾病，需要进行手术 癌症控制所需的。 这些患者可能面临重大 继发性或继发性后言语和吞咽功能的功能障碍 “挽救”手术。 这项研究将检查功能障碍和 该患者组在 12 个月内经历了功能恢复 手术干预后的一段时间。 功能状态也将 与接受手术治疗的头颈癌患者相比 以及接受初级放射治疗的患者的加/减 化疗。 应计人员将包括 50 名计划接受前路手术的患者 口腔切除术（例如口腔舌、口腔前底或侧底） 口腔）和 50 名计划进行后口腔切除术的患者 （例如，舌根、扁桃体、咽侧壁）。 这项研究是 旨在： 1) 确定言语障碍的程度 口腔癌或口咽癌患者的吞咽功能 放射治疗初次治疗后复发或残留疾病 已接受手术治疗的加/减化疗；并确定 言语和吞咽功能如何发挥作用，以及就业、社会化和 手术后 1、3、6 和 12 个月饮食状态随时间变化 与术前功能相比； 2）确定相对贡献 先前的放疗加/减化疗和当前的手术 对言语和吞咽功能损害程度进行干预； 确定复发时间是否影响术后言语 和吞咽功能；判断是否有功能 复发病灶患者与残留病灶患者之间的差异 手术前和手术后； 3）比较言语和吞咽功能 经手术治疗的口腔或口咽癌复发或复发的患者 与相似患者的残留病灶 接受过手术或手术后的切除/重建的人 仅进行手术放射治疗； 4）比较言语和吞咽功能 接受手术治疗的口腔或口咽癌复发患者 或与接受治疗的类似癌症患者有残留疾病 放疗加/减化疗。 这些目标的实现 将确定所经历的功能缺陷和严重程度 经手术治疗的复发性口腔或口咽癌患者 或放射治疗加/减初次治疗后残留病灶 化疗，并提供有关相对功能状态的信息 接受各种治疗方式的患者。