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影响晚期口腔和口咽恶性肿瘤治疗后吞咽结果的因素。

Factors affecting swallow outcome following treatment for advanced oral and oropharyngeal malignancies.

机构信息

University College London Hospital, Head and Neck Cancer Service, London, United Kingdom.

出版信息

Head Neck. 2014 Jan;36(1):47-54. doi: 10.1002/hed.23262. Epub 2013 Apr 4.

Abstract

BACKGROUND

Treatment for tumors of the oral cavity and the oropharynx disrupts normal swallow function. The ability for oral diet postoperatively varies and may be influenced by surgery and patient-related factors.

METHODS

In all, 114 patients treated with surgery with and without chemoradiotherapy for advanced oral/oropharyngeal cancer were recruited. Clinicopathologic tumor parameters and reconstruction modalities were recorded. Swallow function was determined by oral intake, using the Functional Oral Intake Scale (FOIS) pretreatment and posttreatment.

RESULTS

The median time to first attaining swallow function was 14 days. Patients were less likely to attain tube independence within 1 year of surgery if they received radiotherapy or had a low FOIS score preoperatively. Patients' time to first attaining swallow function postsurgery was inversely related to the FOIS score presurgery.

CONCLUSIONS

Swallow function recovery postsurgery is better in patients with higher FOIS presurgery, smaller tumors, and no requirement for radiotherapy.

摘要

背景

口腔和口咽肿瘤的治疗会破坏正常的吞咽功能。术后能否经口进食的能力存在差异,可能受到手术和患者相关因素的影响。

方法

共招募了 114 例接受手术治疗和(或)放化疗的晚期口腔/口咽癌患者。记录了临床病理肿瘤参数和重建方式。通过术前和术后使用功能性口腔摄入量表(FOIS)评估的口腔摄入情况来确定吞咽功能。

结果

首次获得吞咽功能的中位时间为 14 天。如果患者接受放疗或术前 FOIS 评分较低,则在术后 1 年内更不可能实现管饲独立。术后患者首次获得吞咽功能的时间与术前 FOIS 评分呈负相关。

结论

术前 FOIS 评分较高、肿瘤较小且无需放疗的患者术后吞咽功能恢复更好。

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