Oropharyngeal Function After Radiotherapy with IMRT

IMRT 放疗后的口咽功能

• 批准号: 7258794
• 负责人: JERILYN A LOGEMANN
• 金额: $ 49.3万
• 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/7258794
• 关键词: Acute; Affect; Articular Range of Motion; Bolus Infusion; Cancer Patient; Cervical; Cervical part of esophagus; Chicago; Data; Deglutition; Deglutition Disorders; Development; Dilatation - action; Disease; Dose; Eating; Effectiveness of Interventions; Elevation; Esophageal; Esophageal Stenosis; Failure; Fibrosis; Head and Neck Cancer; Head and neck structure; Hylobates Genus; Intake; Intensity-Modulated Radiotherapy; Intervention; Laboratories; Larynx; Maintenance; Malignant Squamous Cell Neoplasm; Malignant neoplasm of pharynx; Measurable; Measures; Methods; Modality; Morbidity - disease rate; Movement; Mucositis; Neck; Normal Range; Normalcy; Numbers; Operative Surgical Procedures; Oral; Oral cavity; Organ; Organ Preservation; Oropharyngeal; Outcome Measure; Pathological Dilatation; Patients; Pharyngeal structure; Physiological; Physiology; Pliability; Production; Protocols documentation; Public Health; Publishing; Radiation; Radiation therapy; Range of motion exercise; Rate; Reporting; Research; Research Personnel; Saliva; Site; Staging; Standards of Weights and Measures; Structure; System; Therapeutic Intervention; Time; Tissues; Tongue; Toxic effect; Treatment Protocols; Universities; Viscosity; Work; Xerostomia; base; cancer surgery; chemotherapy; design; head and neck cancer patient; improved; pressure; programs; response; success; theories; tongue root; treatment effect; tumor

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）：该五年期项目旨在确定在器官保存治疗方案中放疗期间强度调制对吞咽的影响，该方案涉及对125名先前未经治疗的III期或IV期疾病的口腔癌、喉癌和咽癌患者进行放化疗，并确定最佳治疗策略。具体目标是：1）确定调强放射治疗对上呼吸消化道/声带（包括颈段食管）不同部位的生理效应，以及患者恢复口服摄入的比率; 2）记录急性毒性、晚期并发症、局部失败和生存率，以及纤维化评级与喉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来补偿吞咽中的生理缺陷（姿势变化、自主吞咽动作、几种推注量）; 4）确定恢复口服摄入的时间、吞咽操作和/或量的影响、食管狭窄的存在和扩张成功的持续时间是否取决于头部和颈部中特定结构的辐射剂量体积; 5）舌根压与食管狭窄发生的关系。将从西北大学和芝加哥大学招募患者。根据吞咽功能、发病率、毒性和存活率定义影响。其他结局指标是维持口咽区域的自主控制（灵活性），如正确产生吞咽动作的能力所示;以及正常推注量变化的颈咽开放持续时间的积极变化。患者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个月接受研究。在每次评估时，患者将接受使用标准方案的吞咽视频荧光镜评估，口腔干燥、粘膜炎和纤维化评估以及疾病状态评估。头颈癌是影响公众健康的严重问题。目前大多数治疗方法是放疗与化疗的结合，这可能导致严重的吞咽问题，这可能使患者不愿意接受这种类型的治疗。该项目试图量化与这种特定治疗相关的吞咽问题以及这些吞咽问题的干预效果。