Lazarus C L, Husaini H, Hu K, Culliney B, Li Z, Urken M, Jacobson A, Persky M, Tran T, Concert C, Palacios D, Metcalfe-Klaw R, Kumar M, Bennett B, Harrison L
Thyroid Head and Neck Cancer Foundation, Mount Sinai Beth Israel, 10 Union Square East, Suite 5B, New York, NY, 10003, USA,
Dysphagia. 2014 Jun;29(3):365-75. doi: 10.1007/s00455-014-9519-8. Epub 2014 Mar 8.
Concomitant chemoradiotherapy provides organ preservation for those patients with head and neck cancer. We report the results of a prospective study that examined functional outcomes and quality of life (QOL) after chemoradiotherapy over the first 6 months post-treatment (tx). Twenty-nine patients with head and neck cancer were treated with chemoradiotherapy. All were seen baseline and 3 and 6 months post-tx. Assessments included the performance status scale (PSS), Karnofsky performance status scale, tongue strength, jaw opening, and saliva weight. QOL was patient-rated using the eating assessment tool (EAT-10), MD Anderson dysphagia inventory, speech handicap index (SHI), and the EORTC H&N35 scale. Repeated-measures ANOVAs were used, with significance at p < 0.05. PSS scores were significantly different across time points. Tongue strength, jaw range of motion (ROM), and saliva weight were significantly lower at 3 and 6 months than at baseline. QOL was significantly worse after tx, although it improved by 6 months as rated with the EAT-10 and the SHI scores were significantly worse at 3 and 6 months. EORTC domains of swallowing, senses, speech, dry mouth, and sticky saliva were significantly worse at 3 and 6 months. Concomitant chemoradiotherapy for treatment of head and neck tumors can result in impaired performance outcomes and QOL over the first 6 months post-tx. However, performance status, tongue strength, jaw ROM, and eating QOL were only mildly impaired by 6 months post-tx. Saliva production and speech QOL remained significantly impaired at 6 months post-treatment. Current studies are examining outcomes at 12 and 24 months post-treatment to better predict outcomes over time in this population.
同步放化疗为那些头颈癌患者提供了器官保留。我们报告了一项前瞻性研究的结果,该研究在治疗后(tx)的前6个月内检查了同步放化疗后的功能结局和生活质量(QOL)。29名头颈癌患者接受了同步放化疗。所有患者在基线时以及治疗后3个月和6个月时接受检查。评估包括体能状态量表(PSS)、卡氏功能状态量表、舌肌力量、张口度和唾液重量。使用进食评估工具(EAT-10)、MD安德森吞咽障碍量表、言语障碍指数(SHI)和欧洲癌症研究与治疗组织(EORTC)H&N35量表对生活质量进行患者自评。采用重复测量方差分析,p<0.05具有统计学意义。PSS评分在不同时间点有显著差异。舌肌力量、下颌活动范围(ROM)和唾液重量在治疗后3个月和6个月时显著低于基线水平。治疗后生活质量显著变差,尽管根据EAT-10评分显示在6个月时有所改善,且SHI评分在治疗后3个月和6个月时显著更差。EORTC吞咽、感觉、言语、口干和唾液黏稠等领域在治疗后3个月和6个月时显著更差。同步放化疗治疗头颈肿瘤在治疗后前6个月可导致功能结局和生活质量受损。然而,治疗后6个月时体能状态、舌肌力量、下颌ROM和进食生活质量仅受到轻度损害。治疗后6个月时唾液分泌和言语生活质量仍显著受损。目前的研究正在检查治疗后12个月和24个月时的结局,以更好地预测该人群随时间的结局。