Swallowing Function Outcomes in Head and Neck Cancer Survivors Followed by a Long-Term Dysphagia Surveillance Protocol.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-05-05 DOI:10.1002/hed.28166

Rohith M Bhethanabotla, Arushi Gulati, Inderpreet K Khalsa, Cara Evans, Claire E Perrin, James J Lappin, Joseph Kidane, Tyler W Crosby, Jason W Chan, Sue S Yom, VyVy N Young, Clark A Rosen, Sarah L Schneider, Patrick K Ha, W John Boscardin, Joey Laus, William R Ryan, Yue Ma

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引用次数: 0

Abstract

Background: This study aimed to evaluate swallow outcomes in head and neck cancer (HNC) survivors enrolled in a long-term dysphagia surveillance protocol following curative intent radiotherapy (RT).

Methods: We conducted a retrospective review of videofluoroscopic swallow studies from 2015 to 2023 in HNC patients treated with RT. Swallow kinematics and function were assessed at baseline, 0-1, 1-2, 2-5, and 5+ years post-RT. Logistic regression models assessed kinematic deviations beyond 2SD from normative and dichotomized outcomes.

Results: Among 638 patients with 1167 VFSS, 14.6% were 2 years post-RT, primarily oral cavity (29.6%) and oropharyngeal (46.7%) cancers treated with adjuvant (chemo) RT (53.3%). At 2 years, 51.3% exhibited abnormal hyolaryngeal movement, 27.5% had pharyngeal contraction abnormalities, and 9.0% had impaired pharyngoesophageal opening. Unsafe swallow was seen in 51.6% with moderate-to-profound dysphagia in 45%.

Conclusion: Dysphagia surveillance revealed significant swallowing impairments in HNC survivors, with unsafe swallowing prevalent in over half of cases 2 years post-RT.

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长期吞咽困难监测方案后头颈癌幸存者的吞咽功能结局。

背景：本研究旨在评估头颈癌（HNC）幸存者在接受治疗意图放疗（RT）后长期吞咽困难监测方案的吞咽结局。方法：我们对2015年至2023年接受rt治疗的HNC患者的影像透视吞咽研究进行了回顾性回顾。在基线、rt后0-1年、1-2年、2-5年和5年以上评估吞咽运动学和功能。逻辑回归模型评估了超过2SD的规范性和二分类结果的运动学偏差。结果：在638例1167例VFSS患者中，14.6%为放疗后2年，主要是口腔（29.6%）和口咽（46.7%）癌，辅助（化疗）放疗（53.3%）。2岁时，51.3%的患者表现为喉运动异常，27.5%的患者表现为咽收缩异常，9.0%的患者表现为咽食管开口受损。不安全吞咽占51.6%，中度至重度吞咽困难占45%。结论：吞咽困难监测显示，HNC幸存者存在明显的吞咽障碍，在放疗后2年，超过一半的患者存在不安全吞咽。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.