Hahn T R, Krüskemper G
Heinrich-Heine-Universität Düsseldorf, Klinik für Kiefer- und Plastische Gesichtschirurgie, Moorenstrasse 5, 40211 Düsseldorf, Germany.
Mund Kiefer Gesichtschir. 2007 Apr;11(2):99-106. doi: 10.1007/s10006-007-0049-5.
The therapy of patients with oral cancer often requires a combination of surgery and radiotherapy. This leads to trauma of healthy tissue. The impact of this side effect on quality of life was investigated. Additionally the impairment of 19 factors was determined (comprehension of speech for unknown others, comprehension of speech for familiar others, eating/swallowing, mobility of the tongue, opening range of the mouth, mobility of lower jaw, mobility of neck, mobility of arms and shoulders, sense of taste, sense of smell, appearance, strength, appetite, respiration, pain, swelling, xerostomia, halitosis).
This retrospective multicenter study was conducted under the auspices of DOESAK (a German, Austrian and Swiss cooperative group on tumors of the maxillofacial region). The Bochum Questionnaire on Rehabilitation was used to determine 147 items. 3894 questionnaires where sent to 43 clinics in Germany, Austria and Switzerland. 1761 questionnaires where returned, while 1411 of them included all of the answers necessary for this study.
686 of 1411 patients where irradiated. Before the beginning of therapy the impairment of the 19 factors was not significantly higher in the group that later received radiotherapy. After therapy there is a significantly higher impairment of the irradiated patients. The factors that are especially worse are xerostomia, swallowing and understanding of speech. The quality of life was not significantly lower.
Although radiotherapy leads to trauma of healthy tissue this method is indicated as it has no significant impact on quality of life. During the rehabilitation physiotherapists should relieve the impairment of speech, eating and swallowing.
口腔癌患者的治疗通常需要手术和放疗相结合。这会导致健康组织受到创伤。本研究调查了这种副作用对生活质量的影响。此外,还确定了19项因素的损伤情况(对陌生人言语的理解、对熟人言语的理解、进食/吞咽、舌头活动度、张口范围、下颌活动度、颈部活动度、手臂和肩部活动度、味觉、嗅觉、外观、力量、食欲、呼吸、疼痛、肿胀、口干、口臭)。
这项回顾性多中心研究是在DOESAK(德国、奥地利和瑞士颌面肿瘤合作组)的支持下进行的。使用波鸿康复问卷来确定147个项目。向德国、奥地利和瑞士的43家诊所发送了3894份问卷。共收回1761份问卷,其中1411份包含本研究所需的所有答案。
1411名患者中有686名接受了放疗。在治疗开始前,后来接受放疗的组中19项因素的损伤并不显著更高。治疗后,接受放疗的患者损伤明显更高。尤其严重的因素是口干、吞咽和言语理解。生活质量没有显著降低。
尽管放疗会导致健康组织受到创伤,但该方法仍被推荐使用,因为它对生活质量没有显著影响。在康复过程中,物理治疗师应减轻言语、进食和吞咽方面的损伤。