Lazarus C L, Husaini H, Falciglia D, DeLacure M, Branski R C, Kraus D, Lee N, Ho M, Ganz C, Smith B, Sanfilippo N
Department of Otolaryngology - Head and Neck Surgery, Beth Israel Medical Center, New York, USA; Thyroid Head and Neck Cancer Foundation, Beth Israel Medical Center, New York, USA.
Thyroid Head and Neck Cancer Foundation, Beth Israel Medical Center, New York, USA.
Int J Oral Maxillofac Surg. 2014 May;43(5):523-30. doi: 10.1016/j.ijom.2013.10.023. Epub 2013 Dec 11.
Tongue strength is reduced in patients treated with chemoradiotherapy for oral/oropharyngeal cancer. Tongue strengthening protocols have resulted in improved lingual strength and swallowing in healthy individuals, as well as in patients following a neurological event. However, no studies have examined the efficacy of tongue strengthening exercises on tongue strength, swallowing, and quality of life (QOL; Head and Neck Cancer Inventory) in patients treated with chemoradiotherapy. A randomized clinical trial examined the effects of a tongue strengthening programme paired with traditional exercises vs. traditional exercises alone. Dependent variables included tongue strength, swallowing, and QOL in a group of patients with oral and oropharyngeal cancer treated with primary radiotherapy with or without chemotherapy. Differences with regard to tongue strength and oropharyngeal swallow efficiency (OPSE) were not observed within or between groups. QOL in the eating and speech domains improved following treatment in both groups. However, the experimental group demonstrated greater impairment in QOL in the social disruption domain following treatment, whereas the control group demonstrated a slight improvement in functioning. Tongue strengthening did not yield a statistically significant improvement in either tongue strength or swallowing measures in this patient cohort. Patient compliance and treatment timing may be factors underlying these outcomes.
接受口腔/口咽癌放化疗的患者舌肌力量会减弱。舌肌强化训练方案已使健康个体以及经历神经系统事件后的患者的舌肌力量和吞咽功能得到改善。然而,尚无研究考察舌肌强化训练对接受放化疗患者的舌肌力量、吞咽功能及生活质量(QOL;头颈癌量表)的效果。一项随机临床试验比较了舌肌强化训练与传统训练相结合和单纯传统训练的效果。因变量包括一组接受单纯放疗或放化疗的口腔和口咽癌患者的舌肌力量、吞咽功能及生活质量。组内和组间在舌肌力量和口咽吞咽效率(OPSE)方面均未观察到差异。两组患者在进食和言语领域的生活质量在治疗后均有所改善。然而,治疗后试验组在社会功能障碍领域的生活质量受损更严重,而对照组在功能方面略有改善。在该患者队列中,舌肌强化训练在舌肌力量或吞咽指标方面均未产生具有统计学意义的改善。患者依从性和治疗时机可能是导致这些结果的因素。