Bleier Benjamin S, Levine Marc S, Mick Rosemarie, Rubesin Stephen E, Sack Stephen Z, McKinney Kibwei, Mirza Natasha
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, USA.
Ann Otol Rhinol Laryngol. 2007 Nov;116(11):837-41. doi: 10.1177/000348940711601108.
We sought to describe the findings of modified barium swallow study after chemoradiation in patients with head and neck cancer and to correlate these findings with clinical variables, including gastrostomy tube dependence and clinical pneumonia.
We retrospectively reviewed 49 patients at a tertiary care center who underwent modified barium swallow study for dysphagia after chemoradiation.
Patients with nonlaryngeal lesions had increased cricopharyngeal impairment (27.8% versus 0.0%; p = .04). Patients who underwent concomitant chemotherapy had increased epiglottic changes relative to those who had radiotherapy alone (66.7% versus 30.8%; p = .05). Clinical pneumonia developed in 31.9% of the patients, and 79.6% required gastrostomy tube placement for a mean duration of 18.1 months.
Chemoradiation effects deglutition at multiple levels. A large percentage of patients will develop pneumonia and feeding tube dependence. This study is among the largest to correlate the results of modified barium swallow studies to clinical variables in this patient population. This study highlights the significant incidence of gastrostomy tube dependence and pneumonia in these patients.
我们试图描述头颈部癌患者放化疗后改良吞钡检查的结果，并将这些结果与包括胃造瘘管依赖和临床肺炎在内的临床变量相关联。
我们回顾性分析了一家三级医疗中心的49例患者，这些患者在放化疗后因吞咽困难接受了改良吞钡检查。
非喉部病变患者的环咽肌功能障碍增加（27.8% 对0.0%；p = 0.04）。与单纯接受放疗的患者相比，接受同步化疗的患者会厌改变增加（66.7% 对30.8%；p = 0.05）。31.9%的患者发生了临床肺炎，79.6%的患者需要放置胃造瘘管，平均持续时间为18.1个月。
放化疗在多个层面影响吞咽功能。很大一部分患者会发生肺炎和依赖喂养管。本研究是将改良吞钡检查结果与该患者群体临床变量相关联的规模最大的研究之一。本研究突出了这些患者中胃造瘘管依赖和肺炎的高发生率。
