Effects of Swallowing Therapy in Head and Neck Cancer

吞咽疗法对头颈癌的影响

• 批准号: 6722760
• 负责人: JERILYN A LOGEMANN
• 金额: $ 74.51万
• 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/6722760
• 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）：头颈癌的治疗通常 由于运动范围减小而导致严重的吞咽问题 咽喉舌根和咽壁的位置改善治疗程序 包括吞咽动作在内的运动范围已经在飞行员数据中显示， 对活动范围缩小的患者有效。本课题 我建议比较两个为期一个月的康复计划 在随机纵向设计中，从治疗后1个月开始 涉及198名接受过头颈癌治疗的患者， 放化，声门上喉切除术，前切除术 皮片缝合，前切除术远端或游离皮瓣缝合， 后路切除伴一期或植皮闭合，或后路切除 远端或游离皮瓣闭合：1）姿势性活动范围扩大 感觉疗法和2）姿势感觉疗法。经过一个月的 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个月进行一个月的治疗再训练。我们 假设患者随机分配到姿势运动范围， 感觉疗法将在术后2个月表现出显著更多的口服摄入 癌症治疗，将保持他们的收益更好地1个月后休息， 在治疗后4个月有更正常的饮食， 肿瘤治疗完成后4、6和12个月的咽部柔韧性 如通过持续时间和颈咽开口的宽度测量的， 吞咽的不同体积比接受姿势感觉治疗的患者。 我们还假设，在活动范围计划的患者将保持 舌根、舌骨、喉和颈咽的运动范围在4、6和 完成肿瘤治疗后12个月， 明显好于体位感觉的患者 程序.成本效益是当今医疗保健的一个关键因素 系统我们认为，活动度/姿势感觉组的患者 在第4、6和12个月时，医疗服务的成本将更低 在肿瘤治疗完成后（在肿瘤治疗后立即、在肿瘤治疗后2个月和8个月）， 完成吞咽治疗）的患者比姿势感觉治疗中的患者 组