Mortensen H R, Jensen K, Aksglæde K, Lambertsen K, Eriksen E, Grau C
Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark,
Dysphagia. 2015 Jun;30(3):304-14. doi: 10.1007/s00455-015-9600-y. Epub 2015 Feb 19.
Many head and neck cancer (HNC) survivors experience reduced quality of life due to radiotherapy (RT)-related dysphagia. The aim of this prospective randomized trial was to evaluate the impact of prophylactic swallowing exercises on swallowing-related outcomes in HNC patients treated with curative RT. Patients treated with primary RT for HNC were candidates for this randomized protocol. Participants in the exercise group were instructed to perform swallowing exercises at home. Participants in the control group were given standard care. Patients were evaluated with modified barium swallow and several other secondary outcome measures at four and nine different time points, respectively. Data were analyzed according to intention-to-treat analyses. A total of 44 consecutive patients were included; 22 in each group. In general, there was no difference between the two groups regarding any of the dysphagia outcomes during and after treatment. Adherence to exercises was poor and dropouts due to especially fatigue were very frequent in both groups. Systematic swallowing exercises had no impact on swallowing outcomes within the first year after RT. Despite repeated supervised sessions, adherence to exercises was a major issue and dropouts were frequent in both the intervention and control group.
许多头颈癌（HNC）幸存者因放疗（RT）相关的吞咽困难而生活质量下降。这项前瞻性随机试验的目的是评估预防性吞咽训练对接受根治性放疗的HNC患者吞咽相关结果的影响。接受原发性放疗治疗HNC的患者是该随机方案的候选者。运动组的参与者被指导在家中进行吞咽训练。对照组的参与者接受标准护理。分别在四个和九个不同时间点对患者进行改良钡剂吞咽检查和其他几个次要结局指标评估。根据意向性分析对数据进行分析。总共纳入了44例连续患者；每组22例。总体而言，两组在治疗期间和治疗后的任何吞咽困难结局方面均无差异。两组对训练的依从性都很差，尤其是因疲劳导致的退出情况非常频繁。在放疗后的第一年内，系统性吞咽训练对吞咽结局没有影响。尽管进行了多次监督训练，但对训练的依从性仍是一个主要问题，干预组和对照组的退出情况都很频繁。
