Department of Communication Sciences and Disorders. Jacksonville University, Jacksonville, FL, United States.
Department of Rehabilitation Sciences, University of Florida, Gainesville, FL, United States.
Respir Physiol Neurobiol. 2021 Nov;293:103702. doi: 10.1016/j.resp.2021.103702. Epub 2021 May 24.
The aim of this study was to investigate differences in reflexive and volitional cough airflows in advanced stage head and neck cancer survivors as it relates to aspiration status and time since treatment. The hypothesis is that those who aspirate several years after treatment completion would demonstrate reduced airflows for all cough parameters compared to those recently status post treatment completion given the known progressive deterioration associated with radiotherapy.
Demographic and airflow data during both reflexive and volitional cough tasks and aspiration status as determined during fiberoptic endoscopic evaluation of swallow function were collected from 33 Head and Neck Cancer (HNC) survivors.
Omnibus MANOVA for dependent airflow variables and independent variables aspiration status, time since treatment and cough type (reflex or volitional) was significant (F(3,1) = 184, p < 0.000) indicating that peak expiratory flow rates (PEFR) were reduced under reflex (mean PEFR 1.88 SD 0.7) versus volitional (mean PEFR 2.3, SD 0.7) cough types; reduced for aspirators versus non-aspirators (F(2,1) = 4.1, p = 0.04) and reduced for those in the subacute versus chronic phase status post Intensity Modulated Radiotherapy (IMRT) (F(2,1) = 10.05, p = 0.002).
Findings of reduced reflexive compared to volitional cough airflows in head and neck cancer survivors are consistent with those from both healthy and other diseased populations. Additional findings that aspirators demonstrate reduced cough airflows compared to non-aspirators supports the hypothesis. Surprisingly, those recently status post treatment completion show worse cough airflows compared to those remotely status post treatment completion.
本研究旨在探讨晚期头颈部癌症幸存者的反射性和自主咳嗽气流之间的差异，因为这与吸入状态和治疗后时间有关。假设是，那些在治疗完成后几年仍有吸入的患者，与治疗完成后不久的患者相比，所有咳嗽参数的气流都会减少，因为与放射治疗相关的已知进行性恶化。
从 33 名头颈部癌症（HNC）幸存者中收集了反射性和自主咳嗽任务期间的人口统计学和气流数据，以及纤维内镜吞咽功能评估中确定的吸入状态。
依赖气流变量和独立变量吸入状态、治疗后时间和咳嗽类型（反射性或自主）的多元方差分析（MANOVA）具有统计学意义（F(3,1) = 184，p < 0.000），表明呼气峰流速（PEFR）在反射性咳嗽（平均 PEFR 1.88，SD 0.7）与自主咳嗽（平均 PEFR 2.3，SD 0.7）类型下降低；在吸入者与非吸入者之间降低（F(2,1) = 4.1，p = 0.04），在接受调强放射治疗（IMRT）后的亚急性与慢性阶段之间降低（F(2,1) = 10.05，p = 0.002）。
在头颈部癌症幸存者中，反射性咳嗽与自主咳嗽气流相比降低的发现与健康人群和其他疾病人群的发现一致。吸入者的咳嗽气流比非吸入者降低的额外发现支持了假设。令人惊讶的是，那些最近治疗后仍有症状的患者比治疗后较长时间的患者的咳嗽气流更差。
