Effects of Swallowing Therapy in Head and Neck Cancer

吞咽疗法对头颈癌的影响

• 批准号: 6622871
• 负责人: JERILYN A LOGEMANN
• 金额: $ 72.55万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6622871
• 关键词: biomechanics; cancer rehabilitation /care; clinical trials; combination therapy; cost effectiveness; disease /therapy duration; dysphagia; fluoroscopy; head /neck neoplasm; human subject; human therapy evaluation; iatrogenic disease; jaw movement; longitudinal human study; medical rehabilitation related tag; neoplasm /cancer therapy; nutrient intake activity; outcomes research; patient oriented research; physical therapy; posture; speech; statistics /biometry; swallowing; time resolved data

DESCRIPTION (provided by applicant): Treatment for head and neck cancer often results in significant swallowing problems because of reduced range of motion of the larynx, tongue base and pharyngeal walls. Therapy procedures to improve range of motion including swallowing maneuvers have been shown in pilot data to be efficacious in patients with reduced range of motion. In this project, we propose to compare two rehabilitation programs introduced for one month beginning at 1 month post-treatment in a randomized longitudinal design involving 198 patients who have been treated for head and neck cancer with chemoradiation, supraglottic laryngectomy, anterior resection with primary or skin graft closure, anterior resection with distal or free flap closure, posterior resection with primary or skin graft closure, or posterior resection with distal or free flap closure: 1) aggressive range of motion with postural sensory therapy and 2) postural sensory therapy. After the one-month of therapy, patients in both therapy arms will receive a one-month rest period followed by a one-month therapy refresher at month 3 post-treatment. We hypothesize that the patients randomized to range of motion with postural sensory therapy will exhibit significantly more oral intake at 2 months post cancer treatment, will maintain their gains better after 1 month rest and will have a more normal diet at 4 months post-treatment and significantly better pharyngeal flexibility at 4, 6 and 12 months after tumor treatment completion as measured by the duration and width of cricopharyngeal opening during swallows of various volumes than patients receiving postural sensory therapy. We also hypothesize that patients in the range of motion program will maintain tongue base, hyoid, laryngeal and cricopharyngeal range of motion at 4, 6 and 12 months after completion of their tumor treatment and that it will be significantly better than that of patients who were on the postural sensory programs. Cost-effectiveness is a critical factor in today's health care system. We believe that patients in the range of motion/postural sensory group will exhibit less cost for medically needed services at 4, 6 and 12 months after completion of tumor treatment (immediately after, 2 and 8 months after completion of swallowing therapy) than patients in the postural sensory therapy group.

描述（由申请人提供）：经常治疗头颈癌 由于运动范围缩小，导致严重的吞咽问题 喉、舌根和咽壁。治疗程序有待改进 飞行员数据显示了包括吞咽动作在内的运动范围 对活动范围缩小的患者有效。在这个项目中，我们 建议比较两个为期一个月的康复计划 从随机纵向设计治疗后 1 个月开始 涉及 198 名接受过头颈癌治疗的患者 放化疗、声门上喉切除术、前切除术 植皮闭合、前切除并远端或游离皮瓣闭合， 后路切除并一期或植皮闭合，或后路切除 远端或游离皮瓣闭合：1）姿势上的积极运动范围 感觉疗法和2）姿势感觉疗法。经过一个月的时间 治疗期间，两个治疗组的患者将接受一个月的休息期 随后在治疗后第 3 个月进行为期一个月的治疗复习。我们 假设患者随机分配不同姿势的运动范围 感觉疗法在 2 个月后将表现出明显更多的口服摄入量 癌症治疗，休息1个月后会更好地保持收益，并且会 治疗后 4 个月饮食更加正常，情况明显好转 肿瘤治疗完成后 4、6 和 12 个月时的咽部灵活性 通过环咽开口的持续时间和宽度来测量 与接受体位感觉治疗的患者相比，吞咽量不同。 我们还假设处于运动范围计划中的患者将维持 舌根、舌骨、喉部和环咽部的运动范围为 4、6 和 肿瘤治疗完成后 12 个月，并且将 明显优于采用姿势感觉的患者 程序。成本效益是当今医疗保健的关键因素 系统。我们认为运动范围/姿势感觉组的患者 4、6 和 12 个月时医疗所需服务的成本将降低 肿瘤治疗完成后（治疗后立即、治疗后 2 个月和治疗后 8 个月） 吞咽治疗的完成）优于体位感觉治疗的患者 团体。