Abstract
Purpose:
The aim of the study was to determine the changes in swallowing function and quality of life in early period after radiotherapy in head and neck cancer (HNC) patients.
Methods:
Fourty patients with HNC were included in the study. Swallowing function was evaluated by Modified Barium Swallowing Study. Penetration-Aspiration Scale was used to determine the penetration aspiration severity. European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and European Organization for the Research and Treatment of Cancer, Quality of Life Assessments in Head and Neck Cancer (EORTC QLQ-H&N35) which are specific to cancer patients with acceptable validity and reliability were used for quality of life assessment. All evaluations were performed three times including before radiotherapy, 1 and 3 months after radiotherapy.
Results:
The aspiration severity were gradually increased after radiotherapy (p<0.001). There was no difference after radiotherapy in all subscales of EORTC QLQ-C30 (p>0.0166). Pain and feeling illness decreased (p<0.001), swallowing problems, dry mouth, sticky saliva (p<0.001), teeth, mouth-opening problems (p<0.016) increased after radiotherapy. There was a moderate, negative correlation between aspiration severity and general health status scale (p<0.001). There was a moderate, positive correlation between aspiration severity and symptom scale, swallowing ability, social eating, dry mouth, sticky saliva and coughing (p<0.05).
Discussion:
It can be concluded that swallowing function and swallowing related quality of life parameters were affected negatively in the early period after radiotherapy despite no change in general quality of life perception. It is important for clinicians to be aware of swallowing disorders and its effects on quality of life in the early period to prevent patients from potential long-term effects of swallowing disorders on general quality of life.
ÖZ
Amaç:
Çalışmanın amacı; baş boyun kanserli (BBK) hastalarda radyoterapi sonrası erken dönemde yutma fonksiyonu ve yaşam kalitesindeki değişiklikleri belirlemektir.
Yöntemler:
Çalışmaya BBK’lı 40 hasta dahil edildi. Yutma fonksiyonu Modifiye Baryum Yutma Çalışması ile değerlendirildi. Penetrasyon aspirasyon şiddetine karar vermek için Penetrasyon Aspirasyon Skalası kullanıldı. Yaşam kalitesi değerlendirmesi için kanser hastalarına özel, geçerliliği ve güvenirliği olan European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) ve European Organization for the Research and Treatment of Cancer, Quality of Life assessments in Head and Neck Cancer (EORTC QLQ-H&N35) ölçekleri kullanıldı. Tüm değerlendirmeler radyoterapi öncesi, radyoterapi sonrası bir ve üç ayda olmak üzere üç defa yapıldı.
Sonuçlar:
Radyoterapi sonrası aspirasyon şiddeti giderek arttı (p<0.001). EORTC QLQ-C30’un tüm alt basamaklarında radyoterapi sonrası fark olmadığı bulundu (p>0.0166). Ağrı ve kendini hasta hissetme azaldı (p<0.001), yutma problemleri, ağız kuruluğu, tükrük yapışkanlığı (p<0.001), diş ve ağız açma problemleri (p<0.016) radyoterapi sonrası arttı. Aspirasyon şiddeti ile genel sağlık durumu arasında orta düzeyde, negatif yönde (p<0.001) ilişki vardı. Aspirasyon şiddeti ile semptom skalası, yutma yeteneği, sosyal yeme davranışı, ağız kuruluğu, tükrük yapışkanlığı ve öksürme arasında orta düzeyde, pozitif yönde ilişki bulundu (p<0.05).
Tartışma:
Radyoterapi sonrası erken dönemde genel yaşam kalitesi algısında değişiklik olmamasına rağmen yutma fonksiyonu ve yutma ile ilişkili yaşam kalitesi parametreleri olumsuz etkilendiği sonucuna varıldı. Klinisyenlerin, hastalarını yutma bozukluğunun genel yaşam kalitesi üzerine olan olası uzun dönem etkilerinden korumak için yutma bozukluğu ve onun yaşam kalitesine etkisinin erken dönemde farkında olmaları önemlidir.
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References
Gotay CC, Moore TD. Assessing quality of life in head and neck cancer. Quality Life Res. 1992;1(1):5–17.
Robbins KT, Storniolo AMS, Kerber C, Vicario D, Seagren S, Shea M, et al. Phase I study of highly selective supradose cisplatin infusions for advanced head and neck cancer. J Clin Oncol. 1994;12(10):2113–20.
The Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemo-therapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med. 1991;324:1685–90.
Karp DD, Vaughn CW, Carter R, Willett B, Heeren T, Calarese P, et al. Larynx preservation using induction chemotherapy plus radiation therapy as an alternative to laryngectomy in advanced head and neck cancer. Am J Clin Oncol. 1991;14(4):273–9.
Pauloski BR. Rehabilitation of dysphagia following head and neck cancer. Phys Med Rehabil Clin N Am. 2008;19(4):889–928.
Nguyen NP, Moltz CC, Frank C, Vos P, Smith HJ, Karlsson U, et al. Evolution of chronic dysphagia following treatment for head and neck cancer. Oral Oncol. 2006;42(4):374–80.
Hutcheson KA, Lewin JS, Barringer D, Lisec A, Gunn GB, Moore MW, et al. Late dysphagia after radiotherapy based treatment of head and neck cancer. Cancer. 2012;118(23):5793–9.
Nguyen NP, Frank C, Moltz CC, Vos P, Smith HJ, Bhamidipati PV, et al. Aspiration rate following chemoradiation for head and neck cancer: An underreported occurrence. Radiother Oncol. 2006;80(3):302–6.
Garcia-Peris P, Paron L, Velasco C, de la Cuerda C, Camblor M, Breton I, et al. Long-term prevalence of oropharyngeal dysphagia in head and neck cancer patients: Impact on quality of life. Clin Nutr. 2007;26(6):710–7.
Gillespie MB, Brodsky MB, Day TA, Lee F, Martin- Harris B. Swallowing- related quality of life after head and neck cancer treatment. Laryngoscope. 2004;114(8):1362–7.
Logemann, JA. Introduction: Definition and basic principles of evaluation and treatment of swallow. In: Logemann JA, editor. Evaluation and treatment of swallowing disorders. Austin/Texas: Pro-ed; 1998. p.1–8.
Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration- aspiration scale. Dysphagia. 1996;11(2):93–8.
Karaduman A, Serel S, Ünlüer Ö, Demir N. Penetrasyon Aspirasyon Skalası: kişiler arası güvenirlik çalışması. Fizyoter Rehabil. 2012;23(3):151–5.
Guzelant A, Goksel T, Ozkok S, Tasbakan S, Aysan T, Bottomley A. The European Organization for Research and Treatment of Cancer QLQ-C30: an examination into the cultural validity and reliability of the Turkish version of the EORTC QLQ-C30. Eur J Cancer Care. 2004;13(2):135–44.
de Graeff A, de Leeuw RJ, Ros WJ, Hordijk GJ, Blijham GH, Winnubst JA. Long term quality of life patients with head and neck cancer. Laryngoscope 2000;110(1):98–106.
Stringer S. Managing dysphagia in palliative care. Prof Nurs. 1999;14(7):489–92.
Nguyen NP, Frank C, Moltz CC, Vos P, Smith HJ, Karlsson U, et al. Impact of dysphagia on quality of life after treatment of headand- neck cancer. Int J Radiat Oncol Biol Phys. 2005;61(3):772–8.
Romesser PB, Romanyshyn JC, Schupak K, Setton J, Riaz N, Wolden SL, et al. Percutaneous endoscopic gastrostomy in oropharyngeal cancer patients treated with intensity-modulated radiotherapy with concurrent chemotherapy. Cancer. 2012;118(24):6072–8.
Patterson JM, McColl E, Carding PN, Hildreth AJ, Kelly C, Wilson JA. Swallowing in the first year after chemoradiotherapy for head and neck cancer: Clinician and patient-reported outcomes. Head Neck. 2014;36(3):352–8.
Eischbruch A, Lyden T, Bradford CR, Dawson LA, Haxer MJ, Miller AE, et al. Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys. 2002;53(1):23–8.
Graner DE, Foote RL, Kasperbauer JL, Stoeckel RE, Okuno SH, Olsen KD, et al. Swallow function in patients before and after intraarterial chemoradiation. Laryngoscope. 2003;113(3):573–9.
Smith RV, Goldman SY, Beitler JJ, Wadler SS. Decreased shortand long- term swallowing problems with altered radiotherapy dosing used in an organ-sparing protocol for advanced pharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2004;130(7):831–6.
Kotz T, Costello R, Li Y, Posner MR. Swallowing dysfunction after chemoradiation for advanced squamous cell carcinoma of the head and neck. Head Neck 2004;26:365–72.
Newman LA, Vieira F, Schwiezer V, Samant S, Murry T, Woodson G, et al. Eating and weight changes following chemoradiation therapy for advanced head and neck cancer. Arch Otolaryngol Head Neck Surg. 1998;124(5):589–92.
Agarwal J, Dutta D, Palwe V, Gupta T, Laskar SG, Budrukkar A, et al. Prospective subjective evaluation of swallowing function and dietary pattern in head and neck cancers treated with concomitant chemo-radiation. J Cancer Res Ther. 2010;6(1):15–21.
Cengiz M, Ozyar E, Esassolak M, Altun M, Akmansu M, Sen M, et al. Assessment of quality of life of nasopharyngeal carcinoma patients with EORTC QLQ-C30 and H&N-35 modules. Int J Radiation Oncol Biol Phys. 2005;63(5):1347–53.
Epstein JB, Emerton S, Kolbinson DA, Le ND, Phillips N, Stevenson- Moore P, et al. Quality of life and oral function following radiotherapy for head and neck cancer. Head Neck. 1999;21(1):1–11.
Ackerstaff AH, Tan IB, Rasch C, Balm AJ, Keus RB, Schornagel JH, et al. Quality of life assessment after supradose selective intraarterial cisplatin and concomitant radiation for inoperable stage IV head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 2002;128(10):1185–90.
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Burcu TALU, Öğrt. Gör 1 Kezban BAYRAMLAR, Prof. Dr..2 Nilgün BEK, Prof. Dr..3
İletişim (Correspondence):
Selen Serel ARSLAN Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, TURKEY Phone: +905356643007 selen.serel@hacettepe.edu.tr
1 Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, TURKEY
2 Hacettepe University, Faculty of Medicine, Department of Radiation Oncology, Ankara, Turkey
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Arslan, S., Demir, N., Cengiz, M. et al. Swallowing and quality of life outcomes early after radiation therapy in head and neck cancer patients. Turk J Physiother Rehabil 26, 20 (2015). https://doi.org/10.7603/s40680-015-0020-6
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DOI: https://doi.org/10.7603/s40680-015-0020-6