Oropharyngeal Function After Radiotherapy with IMRT

IMRT 放疗后的口咽功能

• 批准号: 7874561
• 负责人: JERILYN A LOGEMANN
• 金额: $ 42.84万
• 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 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7874561
• 关键词: Acute; Affect; Aftercare; Articular Range of Motion; Bolus Infusion; Cancer Patient; Cervical; Cervical part of esophagus; Chicago; Data; Deglutition; Deglutition Disorders; Development; Dilatation - action; Disease; Dose; Eating; 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; Operative Surgical Procedures; Oral; Oral cavity; Organ; Organ Preservation; Oropharyngeal; Outcome Measure; Patients; Pharyngeal structure; Physiological; Physiology; Production; Protocols documentation; Public Health; Publishing; Radiation; Radiation therapy; Reporting; Research; Research Personnel; Saliva; Site; Staging; Structure; System; Therapeutic Intervention; Time; Tissues; Tongue; Toxic effect; Treatment Protocols; Universities; Viscosity; Work; Xerostomia; base; cancer surgery; chemotherapy; design; flexibility; head and neck cancer patient; improved; neuromuscular; pressure; programs; response; success; theories; tongue root; treatment effect; treatment strategy; 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）：这个为期五年的项目旨在确定在器官保存治疗方案中放射治疗期间强度调节对吞咽的影响，该治疗方案包括对125例先前未治疗的III期或IV期口腔、喉癌和咽癌患者进行放化疗，并确定最佳治疗策略。具体目的是：1)确定IMRT放化疗对上气道消化/声道各部位（包括颈道）的生理影响以及患者恢复口服摄入的速度；2)记录急性毒性、晚期并发症、局部衰竭和生存，以及纤维化等级与喉抬高测量的关系；3)确定患者的吞咽机制是否可以通过引入干预措施（体位改变、自主吞咽动作、几次服药量）来弥补吞咽的生理性缺陷；4)确定恢复口服摄入的时间、吞咽动作和/或体积的影响、食管狭窄的存在以及扩张成功的持续时间取决于头颈部特定结构的辐射剂量和体积；5)明确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、毒性和生存来定义的。其他结果测量是口咽区自主控制（灵活性）的维持，如正确进行吞咽动作的能力所示；环咽部开口持续时间随正常丸量变化呈阳性变化。患者将在放化疗完成后的1个月、3个月、6个月、12个月和24个月进行研究。在每次评估中，患者将接受使用标准方案的吞咽视频透视评估、口干、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。目前的大多数治疗方法是放疗和化疗的结合，这可能导致严重的吞咽问题，这可能使患者不愿接受这种治疗。该项目试图量化与这种特殊治疗相关的吞咽问题以及干预措施对这些吞咽问题的影响。

项目成果

A computational tool for the efficient analysis of dose-volume histograms from radiation therapy treatment plans.

• DOI: 10.1120/jacmp.v11i1.3013
• 发表时间: 2010-01-28
• 期刊: Journal of applied clinical medical physics
• 影响因子: 2.1
• 作者: Pyakuryal A;Myint WK;Gopalakrishnan M;Jang S;Logemann JA;Mittal BB
• 通讯作者: Mittal BB

Effect of induction chemotherapy on swallow physiology and saliva production in patients with head and neck cancer: a pilot study.

诱导化疗对头颈癌患者吞咽生理和唾液产生的影响：一项试点研究。

• DOI: 10.1002/hed.23635
• 发表时间: 2015
• 期刊: Head & neck
• 作者: Mittal,BharatB;Pauloski,BarbaraRoa;Rademaker,AlfredW;Discekici-Harris,Muveddet;Helenowski,IreneB;Mellot,Ann;Agulnik,Mark;Logemann,JerilynA
• 通讯作者: Logemann,JerilynA

Development of a standardized method for contouring the larynx and its substructures.

• DOI: 10.1186/s13014-014-0285-4
• 发表时间: 2014-12-11
• 期刊: Radiation oncology (London, England)
• 作者: Choi M;Refaat T;Lester MS;Bacchus I;Rademaker AW;Mittal BB
• 通讯作者: Mittal BB

Dose-volume relationship for laryngeal substructures and aspiration in patients with locally advanced head-and-neck cancer.

局部晚期头颈癌患者喉部亚结构和误吸的剂量-体积关系。

• DOI: 10.1186/s13014-019-1247-7
• 发表时间: 2019
• 期刊: Radiation oncology (London, England)
• 作者: Petras,KatarinaG;Rademaker,AlfredW;Refaat,Tamer;Choi,Mehee;Thomas,TaritaO;Pauloski,BarbaraR;Mittal,BharatB
• 通讯作者: Mittal,BharatB