Maruo Takashi, Sakuraba Minoru, Shinozaki Takeshi, Tomioka Toshifumi, Okano Wataru, Arahira Satoko, Iino Yoshie, Hayashi Ryuichi
Department of Otorhinolaryngology, Nagoya University, Nagoya, Aichi 466-8550, Japan.
Department of Plastic Surgery, Iwate Medical School, Morioka, Iwate 020-8505, Japan.
Oncol Lett. 2018 May;15(5):7355-7361. doi: 10.3892/ol.2018.8213. Epub 2018 Mar 8.
For recurrent cases or residual cases following concomitant chemo-radiation therapy (CCRT), salvage surgery is a frequently used treatment options. A swallowing disorder is one of the major complications of CCRT. The purpose of the present study was to evaluate the effect of CCRT on swallowing function in patients who underwent salvage total pharyngo-laryngo-esophagectomy (TPLE), and to evaluate the importance of pharyngeal constriction in patients who underwent TPLE. Between 2008 January and 2014 May, 54 patients were treated with salvage TPLE following CCRT or TPLE at the National Cancer Center Hospital East, Chiba, Japan and were included in the present study. A total of 14 patients underwent salvage TPLE following CCRT for recurrence or residual tumor (the salvage TPLE group), and 40 patients underwent TPLE as initial treatment (the TPLE group). The pharyngeal constriction score and the post-swallowing oropharyngeal residue rate were evaluated, and inadequate velopharyngeal closure was assessed by videofluorography. The pharyngeal constriction score of the salvage TPLE group was poorer than that of the TPLE group (P<0.05). The bolus residue in the oropharynx was significantly larger in the salvage TPLE group than in the TPLE group (P<0.05). With regards to inadequate velopharyngeal closure, there was no significant difference between the TPLE group and the salvage TPLE group (P>0.99). The results of the present study indicate that the swallowing function of patients who undergo salvage TPLE may be affected by CCRT.
对于同步放化疗（CCRT）后的复发病例或残留病例，挽救性手术是常用的治疗选择。吞咽障碍是CCRT的主要并发症之一。本研究的目的是评估CCRT对接受挽救性全下咽-喉-食管切除术（TPLE）患者吞咽功能的影响，并评估咽缩功能在接受TPLE患者中的重要性。2008年1月至2014年5月期间，日本千叶国立癌症中心东医院54例接受CCRT或TPLE后接受挽救性TPLE治疗的患者被纳入本研究。共有14例患者因复发或残留肿瘤在CCRT后接受挽救性TPLE（挽救性TPLE组），40例患者接受TPLE作为初始治疗（TPLE组）。评估咽缩评分和吞咽后口咽残留率，并通过电视荧光吞咽造影评估腭咽闭合不全情况。挽救性TPLE组的咽缩评分低于TPLE组（P<0.05）。挽救性TPLE组口咽内的食团残留明显多于TPLE组（P<0.05）。关于腭咽闭合不全，TPLE组和挽救性TPLE组之间无显著差异（P>0.99）。本研究结果表明，接受挽救性TPLE患者的吞咽功能可能受CCRT影响。
