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喉癌放疗后嗓音康复效果的 3 年随访:一项随机对照试验。

Effect of voice rehabilitation following radiotherapy for laryngeal cancer - a 3-year follow-up of a randomised controlled trial.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

Acta Oncol. 2022 Mar;61(3):349-356. doi: 10.1080/0284186X.2021.1995891. Epub 2021 Nov 21.

Abstract

OBJECTIVES

This study aims to report on the effectiveness of voice rehabilitation following radiotherapy for laryngeal cancer in a long-term perspective, i.e., up to three years after completion of radiotherapy.

METHODS

The study included a total of 74 patients that were randomised into an intervention group ( = 37) or a control group ( = 37). Voice recordings with blinded assessment of voice quality with the GRBAS protocol (Grade, Roughness, Breathiness, Asthenia, Strain) and acoustic analysis was performed at baseline, 12 and 36 months following radiotherapy. Voice rehabilitation was performed in 10 sessions immediately following completion of radiotherapy. Patients also filled out the Swedish Self-Evaluation of Communication Experiences after Laryngeal cancer.

RESULTS

The S-SECEL demonstrated statistically significant improvements in the intervention group when comparing baseline and 36 months, and no changes in the control group. Acoustic measures did not reveal any significant changes. The perceptual analysis demonstrated that when comparing the changes within the groups between baseline and 36 months there were statistically significant differences between the intervention and control group regarding the voice qualities Roughness, Breathiness and Strain. In the control group, 50% demonstrated deterioration in roughness, while in the intervention group only 7% deteriorated during this time. In Breathiness and Strain, 57 and 50%, respectively, improved in the intervention group, while only 32% and 23% improved, respectively, in the control group.

CONCLUSION

Voice rehabilitation following radiotherapy for laryngeal cancer demonstrate positive effects in patient reported outcomes and perceptual measures of voice quality, and the effects remain up to three years following radiotherapy.

摘要

目的

本研究旨在从长期角度(即放疗完成后三年)报告喉癌放疗后嗓音康复的效果。

方法

本研究共纳入 74 例患者,随机分为干预组(n=37)和对照组(n=37)。在放疗结束后 12 个月和 36 个月时,使用 GRBAS 协议(音质等级、粗糙程度、气息声、无力、紧张度)进行嗓音录音和盲法评估,并进行声学分析。在放疗结束后立即进行 10 次嗓音康复治疗。患者还填写了《喉癌患者交流体验自评量表》(S-SECEL)。

结果

与基线相比,干预组的 S-SECEL 在 36 个月时显示出统计学上的显著改善,而对照组则没有变化。声学测量也没有显示出任何显著变化。感知分析表明,在组内比较基线和 36 个月之间的变化时,干预组和对照组在 Roughness、Breathiness 和 Strain 等声音质量方面存在统计学显著差异。在对照组中,50%的患者粗糙度恶化,而在干预组中,只有 7%的患者在此期间恶化。在 Breathiness 和 Strain 方面,干预组分别有 57%和 50%的患者得到改善,而对照组分别只有 32%和 23%的患者得到改善。

结论

喉癌放疗后的嗓音康复在患者报告的结局和嗓音质量的感知测量方面显示出积极的效果,并且这种效果在放疗后三年仍然存在。

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