Teguh David N, Levendag Peter C, Sewnaik Aniel, Hakkesteegt Marieke M, Noever Inge, Voet Peter, van der Est Henrie, Sipkema Dick, van Rooij Peter, Baatenburg de Jong Robert Jan, Schmitz Paul I M
Department of Radiation Oncology, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Radiother Oncol. 2008 Oct;89(1):57-63. doi: 10.1016/j.radonc.2008.07.012. Epub 2008 Aug 20.
Dysphagia is a serious complaint but frequently underreported. This paper assesses for oropharyngeal cancer (OPC) the relationship between the dose received by the swallowing structures, and the findings of a fiberoptic endoscopic evaluation of the swallowing process (FEES).
Between 2000 and 2005, 60 of 67 OPC patients local-regionally NED for at least one year following treatment responded to three types of QoL questionnaires; i.e. Performance Status Scales, EORTC H&N35, and M.D. Anderson Dysphagia Inventory. Twenty-four patients agreed to the FEES procedure. The main swallowing muscles were delineated, with the mean dose per muscle calculated using the original 3D CT-based treatment plans. Regression analysis was performed between FEES variables and the doses in the different swallowing muscles and the dysphagia related questionnaires.
A significant relationship was found between the results of FEES and the mean dose in the superior constrictor muscle (SCM). Some of the subjective dysphagia complaints were significantly correlated with the FEES variables in this retrospectively study.
A higher dose in the SCM generally results in worsening of the findings obtained by the FEES examination.
吞咽困难是一项严重的主诉，但常常报告不足。本文评估口咽癌（OPC）吞咽结构所接受的剂量与吞咽过程的纤维内镜评估（FEES）结果之间的关系。
2000年至2005年间，67例接受治疗后局部区域无疾病证据（NED）至少一年的OPC患者中有60例对三种类型的生活质量问卷做出了回应；即性能状态量表、欧洲癌症研究与治疗组织（EORTC）H&N35以及MD安德森吞咽困难量表。24例患者同意接受FEES检查。勾画出主要吞咽肌肉，使用基于原始三维CT的治疗计划计算每块肌肉的平均剂量。对FEES变量与不同吞咽肌肉中的剂量以及吞咽困难相关问卷进行回归分析。
在FEES结果与咽下缩肌（SCM）的平均剂量之间发现了显著关系。在这项回顾性研究中，一些主观吞咽困难主诉与FEES变量显著相关。
SCM中较高的剂量通常会导致FEES检查结果恶化。
