Speech-Language Pathology Department, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
Clínica São Judas, São Paulo, SP, Brazil.
Support Care Cancer. 2023 Dec 14;32(1):21. doi: 10.1007/s00520-023-08215-2.
The aim of this study is to investigate the relation between symptoms and signs of oropharyngeal dysphagia after treatment for head and neck cancer.
An observational analytical study with retrospective and prospective components was carried out including 25 adult and elderly patients with head and neck cancer who had completed the treatment at least 3 months before data collection. Data from the Eating Assessment Tool (EAT-10) protocol were analyzed, as well as from the videofluoroscopic swallowing exams. Based on videofluoroscopy, the degree of oropharyngeal dysphagia was classified, as well as the safety and efficiency grade using the DIGEST (Dynamic Imaging Grade of Swallowing Toxicity) scale. Pearson's correlation test was applied, adopting a significance level of 5%.
There was a significant correlation between question 4 of the EAT-10 (swallowing solids takes extra effort) and the efficiency profile (p = 0.004), as well as between question 4 and the DIGEST score (p = 0.002). No significant relation was found between the DIGEST score and EAT-10 total score (p = 0.180) and not even between EAT-10 total score and efficiency (p = 0.129) or safety grade (p = 0.878).
In conclusion, no relation was found between most of the dysphagia signs and symptoms investigated, demonstrating that the individual's perception of the swallowing function may not be consistent with the findings of the instrumental evaluation after long-term treatment for head and neck cancer.
本研究旨在探讨头颈部癌症治疗后口咽吞咽困难症状与体征之间的关系。
本研究为前瞻性和回顾性观察分析研究,共纳入 25 例头颈部癌症成年和老年患者,这些患者在数据收集前至少已完成治疗 3 个月。分析了进食评估工具(EAT-10)协议中的数据,以及视频荧光透视吞咽检查的数据。根据视频荧光透视检查,对口咽吞咽困难程度进行分类,并使用 DIGEST(吞咽毒性动态成像分级)量表对安全性和效率等级进行分级。采用 Pearson 相关检验,检验水准为 5%。
EAT-10 的第 4 题(吞咽固体食物费力)与效率分级呈显著相关(p=0.004),与 DIGEST 评分也呈显著相关(p=0.002)。DIGEST 评分与 EAT-10 总分之间无显著相关性(p=0.180),EAT-10 总分与效率或安全性分级之间也无显著相关性(p=0.129 和 p=0.878)。
综上所述,我们发现大多数研究的吞咽困难症状与体征之间无相关性,这表明在头颈部癌症长期治疗后,个体对吞咽功能的感知可能与仪器评估结果不一致。