Oropharyngeal Function After Radiotherapy with IMRT

IMRT 放疗后的口咽功能

• 批准号: 7142236
• 负责人: JERILYN A LOGEMANN
• 金额: $ 49.42万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-10 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7142236
• 关键词: clinical research; oral pharyngeal; swallowing

DESCRIPTION (provided by applicant): This five-year project proposes to define the effects on swallowing of intensity modulation during radiotherapy in an organ preservation treatment protocol involving chemoradiation for 125 oral, laryngeal, and pharyngeal cancer patients with previously untreated Stage III or IV disease and to identify optimum treatment strategies. The specific aims are: 1) define the physiologic effects of chemoradiotherapy with IMRT to various sites in the upper aerodigestive/vocal tract icluding the cervical esophagus and the rate at which patients return to oral intake; 2) document the acute toxicities, late complications, locoregional failure and survival, and the relationship between fibrosis rating and the measure of laryngeal elevation; 3) determine whether the patient's swallowing mechanism can compensate for physiologic deficits in swallowing by introduction of interventions (postural changes, voluntary swallow maneuvers, several bolus volumes); 4) determine whether time to return to oral intake, effects of swallow maneuvers and/or volume, presence of an esophageal stricture and the duration of success of dilatation depends on radiation dose volume to specific structures in the head and neck; 5) define the relationship of tongue base pressure to development of esophageal stricture. Patients will be accrued from Northwestern University and University of Chicago. Effects are defined in terms of swallowing function, morbidity, toxicity and survival. Other outcome measures are the maintenance of voluntary control (flexibility) of the oropharyngeal region as indicated by the ability to correctly produce swallow maneuvers; and positive changes in cricopharyngeal opening duration with normal bolus volume shifts. Patients will be studied pretreatment, and at 1 month, 3 months, 6 months, 12 months, and 24 months post completion of chemoradiation. At each assessment, patients will receive a videofluoroscopic assessment of swallowing utilizing a standard protocol, assessment of xerostomia, mucositis, and fibrosis as well as assessment of disease status. Head and neck cancer is a severe problem that affects public health. Most current treatments are a combination of radiotherapy with chemotherapy, which can result in severe swallowing problems which may make patients unwilling to accept this type of treatment. This project attempts to quantify the swallow problems associated with this specific treatment and the effects of interventions for these swallow problems.

描述（由申请人提供）：这个为期五年的项目旨在确定器官保存治疗方案中放疗期间强度调节对吞咽的影响，该方案涉及 125 名先前未经治疗的 III 期或 IV 期疾病的口腔癌、喉癌和咽癌患者的放化疗。具体目标是： 1) 确定 IMRT 放化疗对上呼吸消化/声道各个部位（包括颈部食管）的生理影响以及患者恢复经口摄入的速度； 2) 记录急性毒性、晚期并发症、局部失败和生存，以及纤维化评级和喉部抬高测量之间的关系； 3) 确定患者的吞咽机制是否可以通过引入干预措施（姿势改变、自愿吞咽动作、多次推注量）来补偿吞咽生理缺陷； 4) 确定恢复经口摄入的时间、吞咽动作和/或吞咽量的影响、食管狭窄的存在以及扩张成功的持续时间是否取决于头颈部特定结构的辐射剂量体积； 5）定义舌根压力与食管狭窄发展的关系。患者将来自西北大学和芝加哥大学。影响是根据吞咽功能、发病率、毒性和生存率来定义的。其他结果指标包括维持口咽区域的自主控制（灵活性），如正确进行吞咽动作的能力所示；环咽张开持续时间随着正常推注体积变化而发生积极变化。将在治疗前以及放化疗完成后 1 个月、3 个月、6 个月、12 个月和 24 个月对患者进行研究。每次评估时，患者将接受使用标准方案的吞咽电视荧光镜评估、口干症、粘膜炎和纤维化的评估以及疾病状态的评估。头颈癌是影响公共健康的严重问题。目前大多数治疗都是放疗和化疗的结合，这可能会导致严重的吞咽问题，从而可能使患者不愿意接受这种治疗。该项目试图量化与这种特定治疗相关的吞咽问题以及针对这些吞咽问题的干预措施的效果。