Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Eur Arch Otorhinolaryngol. 2022 Feb;279(2):1003-1027. doi: 10.1007/s00405-021-06870-x. Epub 2021 May 27.
The objective was to assess swallowing, mouth opening and speech function during the first year after radiation-based treatment (RT(+)) after introduction of a dedicated preventive rehabilitation program for stage III-IV oropharyngeal carcinoma (OPC).
Swallowing, mouth opening and speech function were collected before and at six- and twelve-month follow-up after RT(+) for OPC as part of ongoing prospective assessments by speech-language pathologists .
Objective and patient-perceived function deteriorated until 6 months and improved until 12 months after treatment, but did not return to baseline levels with 25%, 20% and 58% of the patients with objective dysphagia, trismus and speech problems, respectively. Feeding tube dependency and pneumonia prevalence was low.
Despite successful implementation, a substantial proportion of patients still experience functional limitations after RT(+) for OPC, suggesting room for improvement of the current rehabilitation program. Pretreatment sarcopenia seems associated with worse functional outcomes and might be a relevant new target for rehabilitation strategies.
在引入针对 III-IV 期口咽癌（OPC）的专门预防康复计划后，评估基于放射治疗（RT(+))后的第一年的吞咽、张口和言语功能。
作为语言病理学家进行的正在进行的前瞻性评估的一部分，在 RT(+)治疗 OPC 之前以及治疗后 6 个月和 12 个月时收集吞咽、张口和言语功能。
客观和患者感知的功能在治疗后 6 个月内恶化，12 个月后改善，但仍未恢复到基线水平，分别有 25%、20%和 58%的患者存在客观吞咽困难、张口困难和言语问题。需要依赖饲管和肺炎的患病率较低。
尽管实施成功，但仍有相当一部分患者在接受 OPC 的 RT(+)治疗后仍存在功能受限，表明当前康复计划仍有改进空间。治疗前的肌肉减少症与更差的功能结局相关，可能是康复策略的一个新的相关目标。
