Rehabilitation Sciences, Western University, London, ON, Canada.
London Health Sciences Centre, London, ON, Canada.
Support Care Cancer. 2021 Mar;29(3):1597-1607. doi: 10.1007/s00520-020-05628-1. Epub 2020 Aug 1.
Patients treated for oropharyngeal cancer (OPC) are at increased risk for functional decline due to cancer-related impairments and treatment toxicities, often leading to recommendations for enteral nutritional support. This study investigated the natural history of weight and swallowing outcomes in patients with and without feeding tube (FT) placement.
Data were collected from electronic medical records of OPC patients treated with (chemo)radiotherapy at a single regional cancer center between January 2013 and December 2015. Weight measurements, Functional Oral Intake Scale (FOIS) scores, Performance Status Scale for Head and Neck Cancer (PSS-HN) normalcy of diet scores, and M.D. Anderson Dysphagia Inventory (MDADI) composite scores were gathered at baseline and at 3-, 6-, and 12-months post-treatment. Patients were grouped based on FT placement and change over time was assessed using linear mixed effects analysis.
Of 122 eligible patients, 38 (31.1%) received a FT (FT group). Compared with baseline, weight decreased significantly at 3 and 6 months in both groups and at 12 months for patients without a FT (NFT group). Swallowing-related quality of life (QoL) decreased significantly at 3 and 6 months only in the NFT group.
OPC patients experience clinically relevant decreases in weight and swallowing-related QoL in the first-year post-treatment irrespective of FT placement. These findings will contribute to improved patient monitoring and communication within the clinical setting which may ultimately lead to better outcomes for those with OPC.
接受口咽癌(OPC)治疗的患者由于癌症相关损伤和治疗毒性而面临功能下降的风险增加,通常需要进行肠内营养支持。本研究调查了有和无喂养管(FT)放置的患者的体重和吞咽结局的自然史。
数据来自于 2013 年 1 月至 2015 年 12 月在一家单一地区癌症中心接受(放)化疗治疗的 OPC 患者的电子病历。在基线以及治疗后 3、6 和 12 个月收集体重测量值、功能性口腔摄入量表(FOIS)评分、头颈部癌症的表现状态量表(PSS-HN)正常饮食评分和 MD 安德森吞咽障碍量表(MDADI)综合评分。患者根据 FT 放置进行分组,并使用线性混合效应分析评估随时间的变化。
在 122 名合格患者中,38 名(31.1%)接受了 FT(FT 组)。与基线相比,两组患者在 3 个月和 6 个月时体重明显下降,无 FT 组(NFT 组)患者在 12 个月时体重也明显下降。仅在 NFT 组,吞咽相关生活质量(QoL)在 3 个月和 6 个月时显著下降。
无论 FT 放置情况如何,OPC 患者在治疗后 1 年内均会经历体重和吞咽相关 QoL 的临床相关下降。这些发现将有助于改善临床环境中的患者监测和沟通,从而最终改善 OPC 患者的结局。