Department of Behavioral Science and Community Health, University of Florida, Gainesville, FL, USA.
Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):210-9. doi: 10.1016/j.ijrobp.2011.06.1954. Epub 2011 Oct 17.
Dysphagia after chemoradiotherapy is common. The present randomized clinical trial studied the effectiveness of preventative behavioral intervention for dysphagia compared with the "usual care."
A total of 58 head-and-neck cancer patients treated with chemoradiotherapy were randomly assigned to usual care, sham swallowing intervention, or active swallowing exercises (pharyngocise). The intervention arms were treated daily during chemoradiotherapy. The primary outcome measure was muscle size and composition (determined by T(2)-weighted magnetic resonance imaging). The secondary outcomes included functional swallowing ability, dietary intake, chemosensory function, salivation, nutritional status, and the occurrence of dysphagia-related complications.
The swallowing musculature (genioglossus, hyoglossuss, and mylohyoid) demonstrated less structural deterioration in the active treatment arm. The functional swallowing, mouth opening, chemosensory acuity, and salivation rate deteriorated less in the pharyngocise group.
Patients completing a program of swallowing exercises during cancer treatment demonstrated superior muscle maintenance and functional swallowing ability.
放化疗后吞咽困难很常见。本随机临床试验研究了预防性行为干预对吞咽困难的有效性，与“常规护理”相比。
58 例头颈部癌症患者接受放化疗，随机分为常规护理、假吞咽干预或主动吞咽运动（咽体操）组。干预组在放化疗期间每天接受治疗。主要观察指标为肌肉大小和组成（通过 T2 加权磁共振成像确定）。次要结局包括功能性吞咽能力、饮食摄入、化学感觉功能、唾液分泌、营养状况和吞咽相关并发症的发生。
在主动治疗组，吞咽肌（颏舌肌、舌骨舌肌和下颌舌骨肌）的结构恶化程度较低。在咽体操组，功能吞咽、张口、化学感觉敏锐度和唾液分泌率下降较少。
在癌症治疗期间完成吞咽运动计划的患者表现出更好的肌肉维持和功能吞咽能力。
