Department of Otolaryngology-Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom.
Head Neck. 2014 Mar;36(3):431-43. doi: 10.1002/hed.23251. Epub 2013 Jul 4.
Swallowing dysfunction following chemoradiation for head and neck cancer is a major cause of morbidity and reduced quality of life. This review discusses 3 strategies that may improve posttreatment swallowing function.
The literature was assessed by a multiauthor team that produced evidence-based recommendations.
(1) Prospective and randomized studies with small cohorts show a trend toward benefits for a preventative exercise program addressing oral and pharyngeal structures. (2) Prospective and retrospective data indicate that better swallowing outcomes are likely when nasogastric tubes are used in preference to gastrostomy tubes to supplement enteral nutrition during chemoradiation. (3) Emerging prospective data with mature results on small cohorts support the hypothesis that radiation dose restriction to swallowing structures using intensity-modulated radiation therapy techniques leads to better swallow outcomes.
This study discusses 3 strategies for improving swallow-related outcomes in patients undergoing chemoradiation for head and neck cancer and identifies areas for future research.
头颈部癌症放化疗后吞咽功能障碍是发病率和生活质量下降的主要原因。本文讨论了 3 种可能改善治疗后吞咽功能的策略。
多作者小组评估了文献，并提出了基于证据的建议。
（1）前瞻性和随机小队列研究显示，针对口腔和咽部结构的预防性锻炼方案有改善的趋势。（2）前瞻性和回顾性数据表明，在放化疗期间，鼻胃管代替胃造口管来补充肠内营养时，吞咽功能的结果可能更好。（3）新兴的前瞻性数据对小队列的成熟结果支持这样一种假设，即使用调强放疗技术限制吞咽结构的放射剂量可改善吞咽结果。
本研究讨论了 3 种策略，以改善头颈部癌症接受放化疗患者的吞咽相关结局，并确定了未来研究的领域。
