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评估口咽癌患者行经口机器人手术后吞咽困难和口干的结局。

Evaluating dysphagia and xerostomia outcomes following transoral robotic surgery for patients with oropharyngeal cancer.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.

Department of Otolaryngology - Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

出版信息

Head Neck. 2021 Dec;43(12):3955-3965. doi: 10.1002/hed.26887. Epub 2021 Oct 7.

Abstract

BACKGROUND

We assessed long-term patient-reported dysphagia and xerostomia outcomes following definitive surgical management with transoral robotic surgery (TORS) in patients with oropharyngeal cancer (OPC) via a cross-sectional survey study.

METHODS

Patients with OPC managed with primary oropharyngeal surgery as definitive treatment at least 1 year ago between 2015 and 2019 were identified. The M. D. Anderson Dysphagia Inventory (MDADI) and Xerostomia Inventory (XI) scores were compared across treatment types (i.e., no adjuvant therapy [TORS-A] vs. adjuvant radiotherapy [TORS+RT] vs. adjuvant chemoradiotherapy [TORS+CT/RT]).

RESULTS

The sample had 62 patients (10 TORS-A, 30 TORS+RT, 22 TORS+CT/RT). TORS-A had clinically and statistically significantly better MDADI scores than TORS+RT (p = 0.03) and TORS+CT/RT (p = 0.02), but TORS+RT and TORS+CT/RT were not significantly different. TORS-A had clinically and statistically significantly less XI than TORS+RT (p < 0.01) and TORS+CT/RT (p < 0.01).

CONCLUSIONS

Patients with OPC who have undergone TORS+RT or TORS+CT/RT following surgery face clinically worse dysphagia and xerostomia outcomes relative to patients who undergo TORS-A.

摘要

背景

我们通过横断面调查研究评估了经口机器人手术(TORS)治疗口咽癌(OPC)患者的长期患者报告吞咽困难和口干结局。

方法

我们确定了 2015 年至 2019 年间至少 1 年前接受原发性口咽手术作为确定性治疗的 OPC 患者。比较了不同治疗类型(即无辅助治疗[TORS-A]、辅助放疗[TORS+RT]、辅助放化疗[TORS+CT/RT])的 M.D.安德森吞咽障碍量表(MDADI)和口干量表(XI)评分。

结果

该样本包括 62 例患者(10 例 TORS-A、30 例 TORS+RT、22 例 TORS+CT/RT)。TORS-A 的 MDADI 评分明显优于 TORS+RT(p=0.03)和 TORS+CT/RT(p=0.02),而 TORS+RT 和 TORS+CT/RT 之间没有显著差异。TORS-A 的 XI 明显低于 TORS+RT(p<0.01)和 TORS+CT/RT(p<0.01)。

结论

与接受 TORS-A 的患者相比,接受 TORS+RT 或 TORS+CT/RT 治疗的 OPC 患者的吞咽困难和口干结局更差。

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