van der Molen Lisette, van Rossum Maya A, Ackerstaff Annemieke H, Smeele Ludi E, Rasch Coen R N, Hilgers Frans J M
Department of Head and Neck Oncology & Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
BMC Ear Nose Throat Disord. 2009 Nov 15;9:10. doi: 10.1186/1472-6815-9-10.
Aim of this study is to thoroughly assess pretreatment organ function in advanced head and neck cancer through various clinical outcome measures and patients' views.
A comprehensive, multidimensional assessment was used, that included quality of life, swallowing, mouth opening, and weight changes. Fifty-five patients with stage III-IV disease were entered in this study prior to organ preserving (chemoradiation) treatment.
All patients showed pretreatment abnormalities or problems, identified by one or more of the outcome measures. Most frequent problems concerned swallowing, pain, and weight loss. Interestingly, clinical outcome measures and patients' perception did no always concur. E.g. videofluoroscopy identified aspiration and laryngeal penetration in 18% of the patients, whereas only 7 patients (13%) perceived this as problematic; only 2 out of 7 patients with objective trismus actually perceived trismus.
The assessment identified several problems already pre-treatment, in this patient population. A thorough assessment of both clinical measures and patients' views appears to be necessary to gain insight in all (perceived) pre-existing functional and quality of life problems.
本研究的目的是通过各种临床结局指标和患者的观点，全面评估晚期头颈癌患者治疗前的器官功能。
采用了一项全面的多维评估，包括生活质量、吞咽功能、张口度和体重变化。55例III-IV期疾病患者在接受器官保留（放化疗）治疗前进入本研究。
所有患者均表现出治疗前的异常或问题，通过一项或多项结局指标得以确定。最常见的问题涉及吞咽、疼痛和体重减轻。有趣的是，临床结局指标和患者的认知并不总是一致。例如，电视荧光透视检查发现18%的患者存在误吸和喉穿透，而只有7名患者（13%）认为这是个问题；7名存在客观牙关紧闭的患者中只有2名实际感觉到牙关紧闭。
该评估发现了这一患者群体在治疗前就存在的几个问题。对临床指标和患者观点进行全面评估，似乎对于深入了解所有（可感知的）已存在的功能和生活质量问题是必要的。
