Lee Esther, Magge Hari, Park Isabel, Shakhtour Leyn, Li Ning-Wei, Schottler Jennifer, Joshi Arjun S, Thakkar Punam G, Goodman Joseph F
Division of Otolaryngology-Head and Neck Surgery George Washington University School of Medicine and Health Sciences Washington District of Columbia USA.
OTO Open. 2023 Mar 24;7(1):e47. doi: 10.1002/oto2.47. eCollection 2023 Jan-Mar.
Identify trends in swallowing outcomes in p16+ oropharyngeal squamous cell carcinoma following neoadjuvant chemotherapy+surgery (NAC+S) versus neoadjuvant chemotherapy+surgery+radiation (NAC+S+R).
Cohort study.
Single academic institution.
Swallowing outcome was measured using a validated questionnaire, MD Anderson Dysphagia Inventory (MDADI). MDADI scores were compared between NAC+S and NAC+S+R groups in short-term (<1 year), middle-term (1-3 years), and long-term (>3 years). Clinical factors associated with MDADI scores were explored using a linear mixed model. Statistical significance was established at < .05.
Sixty-seven patients met the inclusion criteria and were divided into 2 groups: NAC+S (57 [85.1%]) and NAC+S+R (10 [14.9%]). All patients had improved MDADI scores in the middle-term compared to short-term (NAC+S: score increase = 3.43, = .002; NAC+S+R: score increase = 11.18, = .044), long-term compared to short-term (NAC+S: score increase = 6.97, < .001; NAC+S+R: score increase = 20.35, < .001), and long-term compared to middle-term (NAC+S: score increase = 3.54, = .043; NAC+S+R: score increase = 9.18, = .026). NAC+S patients had better MDADI scores than NAC+S+R patients at short-term (83.80 vs 71.26, = .001). There was no significant difference in swallowing function in the middle-term or long-term.
Regardless of treatment type, swallowing will likely be improved in the middle-term and long-term compared to the short-term. Patients treated with NAC+S+R will have worse short-term swallowing function. However, in the middle-term and long-term, there is no significant difference in swallowing function between patients treated with NAC+S and NAC+S+R.
确定在接受新辅助化疗+手术（NAC+S）与新辅助化疗+手术+放疗（NAC+S+R）后，p16+口咽鳞状细胞癌患者吞咽功能的变化趋势。
队列研究。
单一学术机构。
使用经过验证的问卷——MD安德森吞咽障碍量表（MDADI）来测量吞咽功能。比较NAC+S组和NAC+S+R组在短期（<1年）、中期（1 - 3年）和长期（>3年）的MDADI评分。使用线性混合模型探索与MDADI评分相关的临床因素。设定统计学显著性水平为<0.05。
67例患者符合纳入标准，分为两组：NAC+S组（57例[85.1%]）和NAC+S+R组（10例[14.9%]）。与短期相比，所有患者在中期的MDADI评分均有所改善（NAC+S组：评分增加=3.43，P=0.002；NAC+S+R组：评分增加=11.18，P=0.044），与短期相比长期也有所改善（NAC+S组：评分增加=6.97，P<0.001；NAC+S+R组：评分增加=20.35，P<0.001），且与中期相比长期仍有改善（NAC+S组：评分增加=3.54，P=0.043；NAC+S+R组：评分增加=9.18，P=0.026）。在短期，NAC+S组患者的MDADI评分优于NAC+S+R组患者（83.80对71.26，P=0.001）。在中期或长期，吞咽功能无显著差异。
无论治疗类型如何，与短期相比，中期和长期的吞咽功能可能会得到改善。接受NAC+S+R治疗的患者短期吞咽功能较差。然而，在中期和长期，接受NAC+S和NAC+S+R治疗的患者在吞咽功能方面无显著差异。
