头颈部癌调强放射治疗与传统放射治疗后吞咽功能的比较。
Comparison of swallowing function after intensity-modulated radiation therapy and conventional radiotherapy for head and neck cancer.
作者信息
Pauloski Barbara Roa, Rademaker Alfred W, Logemann Jerilyn A, Discekici-Harris Muveddet, Mittal Bharat B
机构信息
Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois.
Department of Preventive Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
出版信息
Head Neck. 2015 Nov;37(11):1575-82. doi: 10.1002/hed.23796. Epub 2014 Aug 1.
Abstract
BACKGROUND
Intensity-modulated radiotherapy (IMRT) is hoped to protect structures important for swallow function. We compared posttreatment swallow function in 7 pairs of patients with head and neck cancer treated with either IMRT or conventional radiotherapy (RT).
METHODS
Patients were matched on tumor characteristics. Swallowing function was evaluated with the modified barium swallow procedure pretreatment and at 3 and 6 months postcancer treatment completion. Swallows were analyzed for bolus transit times, bolus residues, laryngeal closure (LAC) duration, cricopharyngeal opening (CPO) duration, and oropharyngeal swallow efficiency (OPSE). Data were analyzed using multifactor repeated measures analysis of variance and adjusted for baseline function.
RESULTS
Main effect of radiation type was significant for all measures on at least 1 bolus type. Patients treated with IMRT demonstrated shorter bolus transit times, less oral and pharyngeal residue, longer LAC, and larger OPSE.
CONCLUSION
Patients treated with IMRT demonstrated faster, more efficient swallows, and greater airway protection.
摘要
背景
调强放射治疗（IMRT）有望保护对吞咽功能重要的结构。我们比较了7对接受IMRT或传统放射治疗（RT）的头颈癌患者治疗后的吞咽功能。
方法
患者根据肿瘤特征进行匹配。在治疗前以及癌症治疗结束后3个月和6个月，采用改良吞钡检查法评估吞咽功能。分析吞咽时的团块通过时间、团块残留、喉关闭（LAC）持续时间、环咽肌开口（CPO）持续时间和口咽吞咽效率（OPSE）。使用多因素重复测量方差分析对数据进行分析，并根据基线功能进行调整。
结果
对于至少一种团块类型的所有测量指标，放射治疗类型的主效应均显著。接受IMRT治疗的患者团块通过时间更短，口腔和咽部残留更少，LAC更长，OPSE更大。
结论
接受IMRT治疗的患者吞咽更快、更有效，且气道保护更好。
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