Karsten Rebecca T, van der Molen Lisette, Hamming-Vrieze Olga, van Son Rob J J H, Hilgers Frans J M, van den Brekel Michiel W M, Stuiver Martijn M, Smeele Ludi E
Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Department of Linguistics, Amsterdam Center for Language and Communication/ACLC-Institute of Phonetic Sciences, University of Amsterdam, Amsterdam, The Netherlands.
Head Neck. 2020 Aug;42(8):1907-1918. doi: 10.1002/hed.26120. Epub 2020 Feb 29.
The objective of this study was to explore the 10-year plus outcomes of Intensity Modulated Radiotherapy with concomitant chemotherapy (CRT) combined with preventive swallowing rehabilitation (CRT+) for head and neck cancer (HNC).
Subjective and objective swallowing, trismus, and speech related outcomes were assessed at 10-year plus after CRT+. Outcomes were compared to previously published 6-year results of the same cohort.
Fourteen of the 22 patients at 6-year follow-up were evaluable. Although objective swallowing-related outcomes showed no deterioration (eg, no feeding tube dependency and no pneumonia), swallowing-related quality of life slightly deteriorated over time. No patients had or perceived trismus. Voice and speech questionnaires showed little problems in daily life. Overall quality of life (QOL) was good.
After CRT with preventive rehabilitation exercises for advanced HNC, swallowing, trismus, and speech related outcomes moderately deteriorated from 6 to 10 years, with an on average good overall QOL after.
本研究的目的是探讨调强放疗联合同步化疗（CRT）并结合预防性吞咽康复（CRT+）治疗头颈癌（HNC）的10年以上疗效。
在CRT+治疗10年以上后评估主观和客观吞咽、张口受限及言语相关结局。将这些结局与同一队列先前发表的6年结果进行比较。
22例患者中14例在6年随访时可进行评估。尽管客观吞咽相关结局没有恶化（如无需依赖鼻饲管且未发生肺炎），但吞咽相关生活质量随时间略有下降。没有患者出现或感觉到张口受限。嗓音和言语问卷显示日常生活中问题较少。总体生活质量（QOL）良好。
对于晚期HNC患者，在CRT联合预防性康复训练后，吞咽、张口受限及言语相关结局在6至10年中出现中度恶化，但总体QOL平均良好。
