1
|
Jamin C, Karam E, Marmouset F, Laure B, Moriniere S, Pare A. Tongue reconstruction after oncological resection: Analysis of the functional outcomes. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101707. [PMID: 38006946 DOI: 10.1016/j.jormas.2023.101707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 11/27/2023]
Abstract
The curative management of oral squamous cell carcinoma can be responsible for swallowing and/or speech impairments. In this study, we analyzed the functional outcomes in patients who underwent an oncological resection and a primary reconstruction of the tongue and/or of the floor of the mouth (TFM). We also investigated the predictive factors for poor functional outcomes. This retrospective study included operated patients from October 2013 to May 2021 at the TOURS University Hospital. We assessed the functional results two years after the completion of the cancer treatment with self-administered questionnaires quantifying swallowing and speech disorders. Thirty-three patients were included and reconstructed with antebrachial free flap (N = 16), local flap (N = 8) or Biodesign ® membrane (N = 9). A higher proportion of pT1 tumor was observed in patient who had a Biodesign-based reconstruction (p = 0.001). There was no significant difference between the groups in terms of postoperative complications or for the duration of enteral feeding. The 21 patients who had an adjuvant radiation therapy had no significant more altered functions. Functional scores were significantly higher in the free flap reconstruction group (DHI =24 and SHI=21) (p = 0.008). No predictive factors for poor outcomes were observed. The repair of TFM defects must be adapted to the resection size. The reconstruction techniques allow to get acceptable functional outcomes even for the greater tumors or in case of radiation therapy. Further research would be required to better identify the predictive factors for poor outcomes.
Collapse
Affiliation(s)
- Cerise Jamin
- Department of Maxillofacial and Plastic Surgery, Tours University Hospital, Avenue de la République, Chambray les Tours 37100, France
| | - Elias Karam
- Department of Visceral Surgery, Tours University Hospital, Avenue de la République, Chambray les Tours 37100, France; School of Medicine, University of François Rabelais, 10 bd Tonnellé, Tours 37000, France
| | - Franck Marmouset
- Department of Otorhinolaryngology, Tours University Hospital, 2 bd Tonnellé, Tours 37000, France
| | - Boris Laure
- Department of Maxillofacial and Plastic Surgery, Tours University Hospital, Avenue de la République, Chambray les Tours 37100, France; School of Medicine, University of François Rabelais, 10 bd Tonnellé, Tours 37000, France
| | - Sylvain Moriniere
- Department of Otorhinolaryngology, Tours University Hospital, 2 bd Tonnellé, Tours 37000, France; School of Medicine, University of François Rabelais, 10 bd Tonnellé, Tours 37000, France
| | - Arnaud Pare
- Department of Maxillofacial and Plastic Surgery, Tours University Hospital, Avenue de la République, Chambray les Tours 37100, France; School of Medicine, University of François Rabelais, 10 bd Tonnellé, Tours 37000, France.
| |
Collapse
|
2
|
Ni BY, Jin HP, Wu W. Therapeutic effects of deep pharyngeal electrical stimulation combined with modified masako maneuver on aspiration in patients with stroke. NeuroRehabilitation 2024; 54:391-398. [PMID: 38607771 DOI: 10.3233/nre-240005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND Stroke patients often experience difficulty swallowing. OBJECTIVE To assist in the improvement of dysphagia symptoms by introducing a novel approach to the treatment of patients with post-stroke aspiration. METHODS A total of 60 patients with post-stroke aspiration were enrolled and divided into an experimental group (n = 30) and a control group (n = 30). The control group received standard treatment, sham intraoral stimulation, and the Masako maneuver, while the experimental group was administered standard treatment, deep pharyngeal electrical stimulation (DPES), and a modified Masako maneuver. Changes in their Functional Oral Intake Scale (FOIS) and Rosenbek scale scores were observed. RESULTS The FOIS scores of both groups increased significantly after treatment (p < 0.01, respectively). The Rosenbek scale scores of both groups decreased significantly after treatment, with the experimental group scoring significantly lower than the control group (1.01±0.09 vs. 2.30±0.82) (p < 0.05). After treatment, the overall response rate in the experimental group (93.33%) was significantly higher than that in the control group (83.33%) (p < 0.001). CONCLUSION In terms of effectively improving dysphagia in aspiration patients after stroke, DPES combined with modified Masako maneuver is clinically recommended.
Collapse
Affiliation(s)
- Bo-Ye Ni
- Department of Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hua-Ping Jin
- Department of Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wei Wu
- Department of Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
3
|
Ninfa A, Jansen F, Delle Fave A, Lissenberg-Witte BI, Pizzorni N, Baatenburg de Jong RJ, Lamers F, Leemans CR, Takes RP, Terhaard CHJ, Schindler A, Verdonck-de Leeuw IM. The Change in Social Eating over Time in People with Head and Neck Cancer Treated with Primary (Chemo)Radiotherapy: The Role of Swallowing, Oral Function, and Nutritional Status. Cancers (Basel) 2023; 15:cancers15051603. [PMID: 36900393 PMCID: PMC10001042 DOI: 10.3390/cancers15051603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
This study aimed at investigating the change in social eating problems from diagnosis to 24 months after primary (chemo)radiotherapy and its associations with swallowing, oral function, and nutritional status, in addition to the clinical, personal, physical, psychological, social, and lifestyle dimensions. Adult patients from the NETherlands QUality of life and BIomedical Cohort (NET-QUBIC) treated with curative intent with primary (chemo)radiotherapy for newly-diagnosed HNC and who provided baseline social eating data were included. Social eating problems were measured at baseline and at 3-, 6-, 12-, and 24-month follow-up, with hypothesized associated variables at baseline and at 6 months. Associations were analyzed through linear mixed models. Included patients were 361 (male: 281 (77.8%), age: mean = 63.3, SD = 8.6). Social eating problems increased at the 3-month follow-up and decreased up to 24 months (F = 33.134, p < 0.001). The baseline-to-24 month change in social eating problems was associated with baseline swallowing-related quality of life (F = 9.906, p < 0.001) and symptoms (F = 4.173, p = 0.002), nutritional status (F = 4.692, p = 0.001), tumor site (F = 2.724, p = 0.001), age (F = 3.627, p = 0.006), and depressive symptoms (F = 5.914, p < 0.001). The 6-24-month change in social eating problems was associated with a 6-month nutritional status (F = 6.089, p = 0.002), age (F = 5.727, p = 0.004), muscle strength (F = 5.218, p = 0.006), and hearing problems (F = 5.155, p = 0.006). Results suggest monitoring social eating problems until 12-month follow-up and basing interventions on patients' features.
Collapse
Affiliation(s)
- Aurora Ninfa
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Femke Jansen
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Mental Health, 1081 HV Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Birgit I. Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit, Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Nicole Pizzorni
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
| | | | - Femke Lamers
- Amsterdam Public Health Research Institute, Mental Health, 1081 HV Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - C. René Leemans
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands
| | - Robert P. Takes
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | | | - Antonio Schindler
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
- Correspondence:
| | - Irma M. Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Mental Health, 1081 HV Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands
- Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, 1081 HV Amsterdam, The Netherlands
| |
Collapse
|
4
|
Gawryszuk A, Bijl HP, van der Schaaf A, Perdok N, Wedman J, Verdonck-de Leeuw IM, Rinkel RN, Steenbakkers RJHM, van den Hoek JGM, van der Laan HP, Langendijk JA. Relationship between videofluoroscopic and subjective (physician- and patient- rated) assessment of late swallowing dysfunction after (chemo) radiation: Results of a prospective observational study. Radiother Oncol 2021; 164:253-260. [PMID: 34592362 DOI: 10.1016/j.radonc.2021.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND PURPOSE Primary (chemo)radiation (CHRT) for HNC may lead to late dysphagia. The purpose of this study was to assess the pattern of swallowing disorders based on prospectively collected objective videofluoroscopic (VF) assessment and to assess the correlations between VF findings and subjective (physician- and patient-rated) swallowing measures. MATERIAL AND METHODS 189 consecutive HNC patients receiving (CH)RT were included. Swallowing evaluation at baseline and 6 months after treatment (T6) encompassed: CTCAE v.4.0 scores (aspiration/dysphagia), PROMs: SWAL QOL/ EORTC QLQ-H&N35 (swallowing domain) questionnaires and VF evaluation: Penetration Aspiration Scale, semi-quantitative swallowing pathophysiology evaluation, temporal measures and oral/pharyngeal residue quantification. Aspiration specific PROMs (aPROMs) were selected. Correlations between late penetration/aspiration (PA_T6) and: clinical factors, CTCAE and aPROMs were assessed using uni- and multivariable analysis. RESULTS Prevalence of PA increased from 20% at baseline to 43% after treatment (p < 0.001). The most relevant baseline predictors for PA_T6 were: PA_T0, age, disease stage III-IV, bilateral RT and baseline aPROM 'Choking when drinking' (AUC: 0.84). In general aPROMs correlated better with VF-based PA than CTCAE scores. The most of physiological swallowing components significantly correlated and predictive for PA (i.e. Laryngeal Vestibular Closure, Laryngeal Elevation and Pharyngeal Contraction) were prone to radiation damage. CONCLUSION The risk of RT-induced PA is substantial. Presented prediction models for late penetration/aspiration may support patient selection for baseline and follow-up VF examination. Furthermore, all aspiration related OARs involved in aforementioned swallowing components should be addressed in swallowing sparing strategies. The dose to these structures as well as baseline PROMs should be included in future NTCP models for aspiration.
Collapse
Affiliation(s)
- Agata Gawryszuk
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
| | - Hendrik P Bijl
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Arjen van der Schaaf
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Nathalie Perdok
- Department of Otolaryngology, Speech Language Pathology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Jan Wedman
- Department of Otolaryngology, Speech Language Pathology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology - Head & Neck Surgery, Amsterdam University Medical Centers, The Netherlands
| | - Rico N Rinkel
- Department of Otolaryngology - Head & Neck Surgery, Amsterdam University Medical Centers, The Netherlands
| | - Roel J H M Steenbakkers
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Johanna G M van den Hoek
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Hans Paul van der Laan
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Johannes A Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands
| |
Collapse
|
5
|
Côté C, Fortin J, Brais B, Youssof S, Gagnon C. Cross-cultural adaptation of the SWAL-QOL and the Sydney Swallow Questionnaire (SSQ) into French-Canadian and preliminary assessment for their use in an oculopharyngeal muscular dystrophy (OPMD) population. Qual Life Res 2021; 31:293-302. [PMID: 34292466 DOI: 10.1007/s11136-021-02915-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Patient-reported outcomes (PRO) assessing dysphagia are an essential component of clinical trials to consider how patients feel and function in response to treatments. The selected PRO needs to be translated in several languages using a systematic process ensuring its validity and equivalence for use in multicenter clinical trials. The main objectives were to translate the SWAL-QOL and the Sydney Swallow Questionnaire (SSQ) into French Canadian (SWAL-QOL-FC and SSQ-FC) and to assess their appropriateness for patients with oculopharyngeal muscular dystrophy (OPMD). METHODS A forward- and back-translation process was followed including independent mother-tongue translators followed by committee review. Known-groups validity was assessed by comparing scores of OPMD French-Canadian participants (n = 21) known to differ in dysphagia severity according to the 80-ml drinking test score. A Mann-Whitney test was used to compare the mean scores. Cognitive interviews were conducted later on to ensure a posteriori cultural equivalence among French-Canadian participants (n = 28). RESULTS Evidences of adequate known-groups validity was shown for the SSQ-FC. Only two domains out of 10 of the SWAL-QOL-FC (burden and eating duration) showed adequate known-groups validity. In addition, the difference in the mean composite score was not significant. Several conceptual equivalence issues were found in both questionnaires as a result of the cognitive interviews. CONCLUSION This study provided evidence that the SSQ-FC presents better validity than the SWAL-QOL-FC in a small sample size of OPMD participants. The findings of the cognitive interviews suggest the need to develop an OPMD-specific questionnaire to capture better the whole spectrum of disease severity.
Collapse
Affiliation(s)
- Claudia Côté
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada. .,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada. .,Centre de recherche Charles-Le Moyne-Saguenay-Lac-St-Jean sur les innovations en santé, University of Sherbrooke, Sherbrooke, Québec, Canada.
| | - Julie Fortin
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada
| | - Bernard Brais
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Sarah Youssof
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Cynthia Gagnon
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne-Saguenay-Lac-St-Jean sur les innovations en santé, University of Sherbrooke, Sherbrooke, Québec, Canada
| |
Collapse
|
6
|
Development of the German Speech Intelligibility Index for the treatment of oral cancer patients. J Craniomaxillofac Surg 2020; 49:52-58. [PMID: 33281030 DOI: 10.1016/j.jcms.2020.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/20/2020] [Accepted: 11/22/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This study aimed at 1) adapting the well-established Speech Handicap Index (SHI) to German, 2) testing the suitability of the instrument for assessing speech-related quality of life, 3) comparing it to the German Voice-Handicap-Index (VHI), in order to support treatment of oral cancer patients who experience posttreatment speech difficulties that affect their quality of life. MATERIAL AND METHODS Participants completed a web-based survey that employed a 2 (experienced problem: speech/articulation-related vs. voice-related) x 2 (SHI vs. VHI) between-subject experimental design, enabling it to distinguish between the experiences of voice and intelligibility impairments, and to determine the discriminatory ability of the two instruments. RESULTS The German SHI reliably assessed speech intelligibility and articulation-related Quality of life. While voice impairments were equally well assessed by both, VHI: M 2.48, SD 0.65; SHI: M 2.52, SD 0.63; only the latter appropriately registered intelligibility handicap in speech impairments (VHI: M 2.05, SD 0.70; SHI: 2.68, SD 0.73). The responsivity of the SHI in capturing the experienced handicap was significantly greater in the speech/articulation-impairment condition (p = .001). CONCLUSION The German SHI is a reliable and responsive measure for speech intelligibility and articulation-related quality of life that should be chosen in preference to the VHI.
Collapse
|
7
|
Keilmann A, Konerding U, Oberherr C, Nawka T. The Articulation Handicap Scale with 12 items (AHS-12): a short form of the Articulation Handicap Index (AHI). LOGOP PHONIATR VOCO 2020; 46:70-76. [DOI: 10.1080/14015439.2020.1757146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Uwe Konerding
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Trimberg Research Academy, University of Bamberg, Bamberg, Germany
| | | | - Tadeus Nawka
- Klinik für Audiologie und Phoniatrie, Charite Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
8
|
Riva G, Elia G, Sapino S, Ravera M, Pecorari G. Validation and Reliability of the Italian Version of the Speech Handicap Index. Folia Phoniatr Logop 2020; 72:43-51. [DOI: 10.1159/000496179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
<b><i>Background:</i></b> Speech problems negatively affect the quality of life of patients with oral and oropharyngeal cancer. An appropriate self-rating questionnaire named Speech Handicap Index (SHI) was developed for these individuals. The aim of this study was the cross-cultural adaptation and the validation of the Italian version of the SHI. <b><i>Methods:</i></b> Fifty-two patients surgically treated for oral or oropharyngeal cancer and 100 healthy individuals without speech articulation disorders were included in the study. An Italian version of the SHI was cross-culturally adapted. Internal consistency, test-retest reliability, construct, and clinical and group validity were calculated. <b><i>Results:</i></b> Cronbach’s alpha coefficient was 0.977. The test-retest reliability was excellent (<i>r</i> between 0.883 and 0.998). There was a good correlation between the total SHI score and the overall speech quality item (<i>p</i> < 0.001), and between the former and speech intelligibility and articulation scales (<i>p</i> < 0.001). The SHI was able to distinguish between patients and healthy subjects (<i>p</i> < 0.001). There was a statistically significant correlation between the total SHI score and tumor stage (<i>p</i> = 0.003). <b><i>Conclusions:</i></b> The Italian version of the SHI showed high values of reliability and validity scores. It is a good instrument to evaluate the impact of speech impairment in patients with oral and oropharyngeal cancer.
Collapse
|
9
|
Patro SK, Panda NK, Bakshi J, Verma RK, Kumar P, Gaba S, John JR. Quality of Life in Patients with Reconstructions After Resections for Oral Cavity Cancers. Indian J Otolaryngol Head Neck Surg 2019; 71:291-300. [PMID: 31741975 DOI: 10.1007/s12070-018-1282-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 02/15/2018] [Indexed: 10/18/2022] Open
Abstract
To determine effects of reconstruction in advanced oral cavity cancers in achieving a quality of life (QOL), which can help patients to cope with their routine day to day activity. A Cross sectional analysis involving 32 patients of stage III and IV oral cavity cancers already operated in the department of otolaryngology and head and neck surgery was carried out. All these patients had resection of their tumors along with reconstruction. Patients who consented for QOL assessment and follow up through personal visit and telephonic interviews were included in the study. Voice related quality of life; Swallowing related QOL; overall Quality of life (WHO QOL BREF II) and disability assessment scale (WHO DAS II) were used for assessing the various QOL parameters during post-operative period. Patients with stage T3 tumors had better QOL compared to patients with T4 stage tumors. Patients who had reconstruction with free flaps had better QOL compared to those with Pectoralis Major myocutaneous (PMMC) flaps or those reconstructed with combinations of flaps involving delto-pectoral flaps or local flaps along with a free flap or PMMC. Patients with lower stage tumors have better QOL even after reconstruction. If available, free flaps should be preferred over local flaps. Delto-pectoral flaps should be a less preferred option in terms of QOL. Every patient should be counseled accordingly while any reconstruction plan is included in the management of cancers of oral cavity.
Collapse
Affiliation(s)
- Sourabha K Patro
- 1Department of Otolaryngology and Head and Neck Surgery, PGIMER, Chandigarh, India.,3Department of ENT and Head and Neck Surgery, AIIMS, Jodhpur, India
| | - Naresh K Panda
- 1Department of Otolaryngology and Head and Neck Surgery, PGIMER, Chandigarh, India
| | - Jaimanti Bakshi
- 1Department of Otolaryngology and Head and Neck Surgery, PGIMER, Chandigarh, India
| | - Roshan K Verma
- 1Department of Otolaryngology and Head and Neck Surgery, PGIMER, Chandigarh, India
| | - Parmod Kumar
- 2Department of Plastic Surgery, PGIMER, Chandigarh, India
| | - Sunil Gaba
- 2Department of Plastic Surgery, PGIMER, Chandigarh, India
| | - Jerry R John
- 2Department of Plastic Surgery, PGIMER, Chandigarh, India
| |
Collapse
|
10
|
Balaguer M, Farinas J, Fichaux-Bourin P, Puech M, Pinquier J, Woisard V. Validation of the French Versions of the Speech Handicap Index and the Phonation Handicap Index in Patients Treated for Cancer of the Oral Cavity or Oropharynx. Folia Phoniatr Logop 2019; 72:464-477. [DOI: 10.1159/000503448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 09/17/2019] [Indexed: 11/19/2022] Open
Abstract
<b><i>Context:</i></b> Nowadays, clinical tools are available to evaluate the functional impact of speech disorders in neurological conditions, but few are validated in oncology. Because of their location, cancers of the upper aerodigestive tract directly impact patients’ communication skills. Two questionnaires exist in French, the Speech Handicap Index (SHI) and the Phonation Handicap Index (PHI), but none are specifically validated for the head and neck cancer population. Our aim is to evaluate the validity of these 2 questionnaires in a population of patients treated for oral cavity or oropharyngeal cancer. <b><i>Material and Method:</i></b> Eighty-seven patients treated for cancer of the oral cavity or oropharynx, and 21 controls filled in the questionnaires during a consultation or 1-day hospitalization. Validation was studied by the analysis of convergent and discriminant validity, clinical validity, criterion validity, and internal consistency. <b><i>Results:</i></b> The 2 questionnaires present a coherent structure in 2 distinct dimensions for the SHI, and in 3 dimensions for the PHI. Both tools discriminate patients and healthy subjects (<i>p</i> value <0.001, Mann-Whitney test). The comparison of the SHI and PHI scores with the “social role functioning” dimension of the Medical Outcome Study Short Form 36 chosen as a reference shows similar performances for the 2 questionnaires (ρ > 0.42). Lastly, the internal consistency is good (Cronbach’s α > 0.71). <b><i>Conclusion:</i></b> In patients treated for oral cavity or oropharyngeal cancer, the SHI and PHI are 2 valid and reliable tools for the self-assessment of speech disability. A limitation can be found about criterion validity, because a true gold standard does not exist at the moment. However, the reduced number of questions of the PHI, which implies a shorter completion, leads to prefer this tool over the SHI.
Collapse
|
11
|
Gondivkar SM, Gadbail AR, Sarode SC, Gondivkar RS, Yuwanati M, Sarode GS, Patil S. Measurement properties of oral health related patient reported outcome measures in patients with oral cancer: A systematic review using COSMIN checklist. PLoS One 2019; 14:e0218833. [PMID: 31247007 PMCID: PMC6597073 DOI: 10.1371/journal.pone.0218833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/10/2019] [Indexed: 01/06/2023] Open
Abstract
Background Oral cancer (OC) is one of the common malignant neoplasm resulting in a range of debilitating symptoms. Patient reported outcome measures (PROMs) could provide a valuable insight into the impact of OC on patients’ quality of life (QoL). Selecting an adequate instrument among available PROMs for OC has been challenging for clinicians due to lack of information on their psychometric quality. This systematic review provides an extensive overview of methodological quality of all currently available PROMs for OC. Method A systematic search was performed in PubMed, Scopus, Web of Science and CINAHL for relevant literature until 10th January 2019 and data was extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the identified studies was assessed per measurement property according to the COnsensus-based Standards for the selection of health Measurements Instruments (COSMIN) checklist. Results Seven studies were found evaluating 6 health-related QoL PROMs. Among six, there were 1 disease-specific and 5 generic PROMs. Information regarding important measurement properties was often incomplete. The evidence for the quality of measurement properties was found to be variable, none of the instruments performed sufficient on all measurement properties. Considering results of this review, QOL-OC appeared to have adequate COSMIN measurement properties. Conclusion QOL-OC can be implemented in future studies to better understand symptoms and expectations of OC patients and help inform clinicians to formulate treatment strategies as per patients’ needs.
Collapse
Affiliation(s)
- Shailesh M. Gondivkar
- Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Amol R. Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra State, India
| | - Sachin C. Sarode
- Department of Oral Pathology & Microbiology, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra State, Pune, India
- * E-mail:
| | | | - Monal Yuwanati
- Department of Oral Pathology & Microbiology, Peoples College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Gargi S. Sarode
- Department of Oral Pathology & Microbiology, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra State, Pune, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| |
Collapse
|
12
|
Jehn P, Stier R, Tavassol F, Dittmann J, Zimmerer R, Gellrich NC, Krüskemper G, Spalthoff S. Physical and Psychological Impairments Associated with Mucositis after Oral Cancer Treatment and Their Impact on Quality of Life. Oncol Res Treat 2019; 42:342-349. [PMID: 30970370 DOI: 10.1159/000499720] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/19/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Posttherapeutic mucositis is a common secondary effect of oral cancer treatment. Mucositis affects the oral mucosa, which leads to specific physical impairments in oral function and a negative impact on quality of life. OBJECTIVE To evaluate the impairments associated with oral mucositis and their impact on posttherapeutic quality of life. METHODS A retrospective analysis was conducted on 1,652 patients treated for oral cancer during the multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumors of the Maxillofacial Region (DÖSAK), which included 43 clinics from Germany, Austria, and Switzerland. The analysis was based on questionnaires filled out by patients following treatment. RESULTS Approximately 10% of 1,652 patients included in our study had physical or psychological impairments due to increased posttreatment oral mucositis; this was mainly due to adjuvant radiotherapy or radiochemotherapy administered. Oral mucositis was significantly associated with specific physical impairments, especially xerostomia and pain (p = 0.000), which required supportive care and analgesia (p = 0.000). Additionally, impaired ingestion and speech significantly led to psychological disorders such as public avoidance behavior and social isolation (p = 0.001). Depressive coping of disease (p = 0.001) and concomitant depressive tendencies (p = 0.004) were highly associated with mucositis, which was accompanied by diminished general condition (p = 0.001), bleak future prospects (p = 0.006), and a reduction in quality of life (p = 0.002). CONCLUSION Minimizing mucositis-related impairments should be a main effort in oral cancer treatment to optimize patient outcome and improve quality of life after therapy.
Collapse
Affiliation(s)
- Philipp Jehn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany,
| | - Rebecca Stier
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Frank Tavassol
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Jan Dittmann
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Rüdiger Zimmerer
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Gertrud Krüskemper
- Department of Medical Psychology, Ruhr University of Bochum, Bochum, Germany
| | - Simon Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| |
Collapse
|
13
|
Dzioba A, Aalto D, Papadopoulos-Nydam G, Seikaly H, Rieger J, Wolfaardt J, Osswald M, Harris JR, O'Connell DA, Lazarus C, Urken M, Likhterov I, Chai RL, Rauscher E, Buchbinder D, Okay D, Happonen RP, Kinnunen I, Irjala H, Soukka T, Laine J. Functional and quality of life outcomes after partial glossectomy: a multi-institutional longitudinal study of the head and neck research network. J Otolaryngol Head Neck Surg 2017; 46:56. [PMID: 28870248 PMCID: PMC5583999 DOI: 10.1186/s40463-017-0234-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/28/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND While aggressive treatment for oral cancer may optimize survival, decrements in speech and swallowing function and quality of life often result. This exploratory study investigated how patients recover their communicative function, swallowing ability, and quality of life after primary surgery [with or without adjuvant (chemo)radiation therapy] for tongue cancer over the course of the first year post-operation. METHODS Patients treated for oral cancer at three institutions (University of Alberta Hospital, Mount Sinai Beth Israel Medical Center, and Turku University Hospital) were administered patient-reported outcomes assessing speech [Speech Handicap Index (SHI)], swallowing [(M.D. Anderson Dysphagia Inventory (MDADI)] and quality of life [European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC-H&N35)]. Outcome measures were completed pre-operatively and at 1-, 6-, and 12-months post-operatively. RESULTS One hundred and seventeen patients undergoing partial glossectomy with reconstruction participated in this study. Results indicated no significant differences in swallowing function (MDADI and EORTC-H&N35 subscales) between baseline and 6 months post-surgery and no significant differences in speech function (SHI subscales) between baseline and 1 year post-surgery. Most quality of life domains (EORTC-H&N35 subscales) returned to baseline levels by 1 year post-operation, while difficulties with dry mouth and sticky saliva persisted. A clear time trend of adjuvant (chemo)radiation therapy negatively affecting dry mouth scores over time was identified in this study, while negative independent effects of chemoradiation on MDADI swallowing, and EORTC-H&N35 swallowing, eating, and opening mouth subscales were found. CONCLUSIONS Assessment time influenced patient-reported speech, swallowing, and quality of life outcomes, while treatment (by time) effects were found for only swallowing and quality of life outcomes. Results of the present study will help guide clinical care and will be useful for patient counseling on expected short and long-term functional and quality of life outcomes of surgical and adjuvant treatment for oral cavity cancer.
Collapse
Affiliation(s)
- Agnieszka Dzioba
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, T6G 2G4, Canada. .,Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, AB, Canada.
| | - Daniel Aalto
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, AB, Canada.,Rehabilitation Medicine, Communication Sciences and Disorders, University of Alberta, Edmonton, AB, Canada.,Department of Oral and Maxillofacial Surgery, University of Turku, Turku, Finland
| | - Georgina Papadopoulos-Nydam
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, AB, Canada.,Rehabilitation Medicine, Communication Sciences and Disorders, University of Alberta, Edmonton, AB, Canada
| | - Hadi Seikaly
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, T6G 2G4, Canada.,Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, AB, Canada.,Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Jana Rieger
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, AB, Canada.,Rehabilitation Medicine, Communication Sciences and Disorders, University of Alberta, Edmonton, AB, Canada
| | - Johan Wolfaardt
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, AB, Canada.,Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Martin Osswald
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, T6G 2G4, Canada.,Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, AB, Canada.,Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Jeffrey R Harris
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, T6G 2G4, Canada.,Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, AB, Canada.,Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Daniel A O'Connell
- Department of Surgery, University of Alberta Hospital, Edmonton, AB, T6G 2G4, Canada.,Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Cathy Lazarus
- Division of Head and Neck Surgery, Department of Otolaryngology, Head & Neck Surgery, Mount Sinai Beth Israel, New York, NY, USA.,Thyroid, Head And Neck Cancer (THANC) Foundation, New York, NY, USA
| | - Mark Urken
- Division of Head and Neck Surgery, Department of Otolaryngology, Head & Neck Surgery, Mount Sinai Beth Israel, New York, NY, USA.,Thyroid, Head And Neck Cancer (THANC) Foundation, New York, NY, USA
| | - Ilya Likhterov
- Division of Head and Neck Surgery, Department of Otolaryngology, Head & Neck Surgery, Mount Sinai Beth Israel, New York, NY, USA.,Thyroid, Head And Neck Cancer (THANC) Foundation, New York, NY, USA
| | - Raymond L Chai
- Division of Head and Neck Surgery, Department of Otolaryngology, Head & Neck Surgery, Mount Sinai Beth Israel, New York, NY, USA.,Thyroid, Head And Neck Cancer (THANC) Foundation, New York, NY, USA
| | - Erika Rauscher
- Thyroid, Head And Neck Cancer (THANC) Foundation, New York, NY, USA
| | - Daniel Buchbinder
- Thyroid, Head And Neck Cancer (THANC) Foundation, New York, NY, USA.,Department of Oral and Maxillofacial Surgery, Mount Sinai Beth Israel, New York, USA
| | - Devin Okay
- Thyroid, Head And Neck Cancer (THANC) Foundation, New York, NY, USA.,Department of Oral and Maxillofacial Surgery, Mount Sinai Beth Israel, New York, USA
| | - Risto-Pekka Happonen
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland.,Department of Oral and Maxillofacial Surgery, University of Turku, Turku, Finland
| | - Ilpo Kinnunen
- Department of Oto-Rhino-Laryngology, Turku University Hospital, Turku, Finland
| | - Heikki Irjala
- Department of Oto-Rhino-Laryngology, Turku University Hospital, Turku, Finland
| | - Tero Soukka
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland.,Department of Oral and Maxillofacial Surgery, University of Turku, Turku, Finland
| | - Juhani Laine
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland.,Department of Oral and Maxillofacial Surgery, University of Turku, Turku, Finland
| | | |
Collapse
|
14
|
Grading Dysphagia as a Toxicity of Head and Neck Cancer: Differences in Severity Classification Based on MBS DIGEST and Clinical CTCAE Grades. Dysphagia 2017; 33:185-191. [PMID: 28836005 DOI: 10.1007/s00455-017-9843-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/18/2017] [Indexed: 01/01/2023]
Abstract
Clinician-reported toxicity grading through common terminology criteria for adverse events (CTCAE) stages dysphagia based on symptoms, diet, and tube dependence. The new dynamic imaging grade of swallowing toxicity (DIGEST) tool offers a similarly scaled five-point ordinal summary grade of pharyngeal swallowing as determined through results of a modified barium swallow (MBS) study. This study aims to inform clinicians on the similarities and differences between dysphagia severity according to clinical CTCAE and MBS-derived DIGEST grading. A cross-sectional sample of 95 MBS studies was randomly selected from a prospectively-acquired MBS database among patients treated with organ preservation strategies for head and neck cancer. MBS DIGEST and clinical CTCAE dysphagia grades were compared. DIGEST and CTCAE dysphagia grades had "fair" agreement per weighted κ of 0.358 (95% CI .231-.485). Using a threshold of DIGEST ≥ 3 as reference, CTCAE had an overall sensitivity of 0.50, specificity of 0.84, and area under the curve (AUC) of 0.67 to identify severe MBS-detected dysphagia. At less than 6 months, sensitivity was 0.72, specificity was 0.76, and AUC was 0.75 while at greater than 6 months, sensitivity was 0.22, specificity was 0.90, and AUC was 0.56 for CTCAE to detect dysphagia as determined by DIGEST. Classification of pharyngeal dysphagia on MBS using DIGEST augments our understanding of dysphagia severity according to the clinically-derived CTCAE while maintaining the simplicity of an ordinal scale. DIGEST likely complements CTCAE toxicity grading through improved specificity for physiologic dysphagia in the acute phase and improved sensitivity for dysphagia in the late-phase.
Collapse
|
15
|
Youssof S, Romero-Clark C, Warner T, Plowman E. Dysphagia-related quality of life in oculopharyngeal muscular dystrophy: Psychometric properties of the SWAL-QOL instrument. Muscle Nerve 2017; 56:28-35. [PMID: 27759888 DOI: 10.1002/mus.25441] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 10/13/2016] [Accepted: 10/18/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The Swallowing Quality of Life instrument (SWAL-QOL) is a patient-reported outcome measure of swallowing-related quality of life (SR-QoL). Its psychometric properties in oculopharyngeal muscular dystrophy (OPMD) are not known. METHODS We administered the SWAL-QOL to U.S. OPMD Registry participants. We described SR-QoL profiles and assessed reliability and validity. RESULTS The mean composite score in 113 individuals with OPMD was 54.4 ± 20.7, indicating moderate impairment. Severe impairments were observed in eating duration, burden, and fatigue scales. Internal consistency reliability of all scales was found to be satisfactory, and 9 of 10 scales demonstrated adequate test-retest reliability. Data confirmed 86% of hypotheses, supporting construct validity. The SWAL-QOL limitations in OPMD include: floor/ceiling effects in 7 of 10 scales and low specificity of sleep, fatigue, and communication scales for dysphagia. CONCLUSIONS SR-QoL is reduced in OPMD. Given several limitations of the SWAL-QOL, development of an improved dysphagia-specific QoL instrument for OPMD is warranted. Muscle Nerve 56: 28-35, 2017.
Collapse
Affiliation(s)
- Sarah Youssof
- Department of Neurology, MSC 10 5620, 1, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, 87131, USA
| | - Carol Romero-Clark
- Speech, Language, Swallow Center, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Teddy Warner
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Emily Plowman
- Speech, Language and Hearing Sciences, Center for Respiratory Research & Rehabilitation, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
16
|
Articulation handicap index: an instrument for quantifying psychosocial consequences of impaired articulation. Eur Arch Otorhinolaryngol 2016; 273:4493-4500. [DOI: 10.1007/s00405-016-4143-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 06/11/2016] [Indexed: 10/21/2022]
|
17
|
Goepfert RP, Lewin JS, Barrow MP, Gunn GB, Fuller CD, Beadle BM, Garden AS, Rosenthal DI, Kies MS, Papadimitrakopoulou V, Lai SY, Gross ND, Schwartz DL, Hutcheson KA. Long-Term, Prospective Performance of the MD Anderson Dysphagia Inventory in "Low-Intermediate Risk" Oropharyngeal Carcinoma After Intensity Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 2016; 97:700-708. [PMID: 27485284 DOI: 10.1016/j.ijrobp.2016.06.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 05/24/2016] [Accepted: 06/07/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To characterize long-term MD Anderson Dysphagia Inventory (MDADI) results after primary intensity modulated radiation therapy (IMRT) for oropharyngeal carcinoma (OPC) among patients with "low-intermediate risk" OPC who would be eligible for current trials (eg, ECOG 3311, NRG HN002, CRUK PATHOS). METHODS AND MATERIALS A retrospective pooled analysis combined data from 3 single-institution clinical trials for advanced-stage head and neck carcinoma. Inclusion criteria were clinical stage III/IV OPC (T1-2/N1-2b, T3/N0-2b) treated with definitive split-field IMRT and prospectively collected MDADI at baseline and at least 1 posttreatment interval available in trial databases. Patients were sampled to represent likely human papillomavirus (HPV)-associated disease (HPV+/p16+ or <10 pack-years if HPV/p16 unknown). The MDADI composite scores were collected at baseline and 6, 12, and 24 months after treatment. Pairwise tests were Bonferroni corrected for multiple comparisons. RESULTS Forty-six patients were included. All received bilateral neck irradiation with a median dose of 70 Gy and systemic therapy (57% concurrent, 43% induction only). Overall the mean baseline MDADI composite score was 90.1, dropping to 74.6 at 6 months (P<.0001) and rising to 78.5 (P<.0001) and 83.1 (P=.002) by 12 and 24 months relative to baseline, respectively, representing a clinically meaningful drop in MDADI scores at 6 months that partially recovers by 24 months (6 vs 24 months, P=.05). Poor MDADI scores (composite <60) were reported in 4%, 11%, 15%, and 9% of patients at baseline and 6, 12, and 24 months, respectively. Fifteen percent of patients had a persistently depressed composite score by at least 20 points at the 24-month interval. CONCLUSION "Low-intermediate risk" patients with OPC treated with laryngeal/esophageal inlet dose-optimized split-field IMRT are highly likely to report recovery of acceptable swallowing function in long-term follow-up. Only 15% report poor swallowing function and/or persistently depressed MDADI at 12 months or more after IMRT. These data serve as a benchmark future trial design and endpoint interpretation.
Collapse
Affiliation(s)
- Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jan S Lewin
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Martha P Barrow
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - C David Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Beth M Beadle
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adam S Garden
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Merrill S Kies
- Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Neil D Gross
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David L Schwartz
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Katherine A Hutcheson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| |
Collapse
|
18
|
Kraaijenga SAC, Lapid O, van der Molen L, Hilgers FJM, Smeele LE, van den Brekel MWM. Feasibility and potential value of lipofilling in post-treatment oropharyngeal dysfunction. Laryngoscope 2016; 126:2672-2678. [DOI: 10.1002/lary.26003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/21/2016] [Accepted: 03/07/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Sophie A. C. Kraaijenga
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute; Amsterdam the Netherlands
| | - Oren Lapid
- Department of Plastic Reconstructive and Hand Surgery; Academic Medical Center; Amsterdam the Netherlands
| | - Lisette van der Molen
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute; Amsterdam the Netherlands
| | - Frans J. M. Hilgers
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute; Amsterdam the Netherlands
| | - Ludwig E. Smeele
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute; Amsterdam the Netherlands
- Department of Oral and Maxillofacial Surgery; Academic Medical Center; Amsterdam the Netherlands
| | - Michiel W. M. van den Brekel
- Department of Head and Neck Oncology and Surgery; The Netherlands Cancer Institute; Amsterdam the Netherlands
- Department of Oral and Maxillofacial Surgery; Academic Medical Center; Amsterdam the Netherlands
- Institute of Phonetic Sciences/ACLC; University of Amsterdam; Amsterdam the Netherlands
| |
Collapse
|
19
|
Philiponis G, Kagan SH. Speaking legibly: Qualitative perceptions of altered voice among oral tongue cancer survivors. Asia Pac J Oncol Nurs 2015; 2:250-256. [PMID: 27981121 PMCID: PMC5123506 DOI: 10.4103/2347-5625.158020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Treatment for oral tongue cancer poses unique challenges to restoring and maintaining personally acceptable, intelligible speech. METHODS We report how oral tongue cancer survivors describe their speech after treatment in a qualitative descriptive approach using constant comparative technique to complete a focal analysis of interview data from a larger grounded theory study of oral tongue cancer survivorship. Interviews were completed with 16 tongue cancer survivors 3 months to 12 years postdiagnosis with stage I-IV disease and treated with surgery alone, surgery and radiotherapy, or chemo-radiation. All interview data from the main study were analyzed for themes describing perceptions of speech as oral tongue cancer survivors. RESULTS Actual speech impairments varied among survivors. None experienced severe impairments that inhibited their daily lives. However, all expressed some level of concern about speech. Concerns about altered speech began when survivors heard their treatment plans and continued through to survivorship without being fully resolved. The overarching theme, maintaining a pattern and character of speech acceptable to the survivor, was termed "speaking legibly" using one survivor's vivid in vivo statement. Speaking legibly integrate the sub-themes of "fears of sounding unusual", "learning to talk again", "problems and adjustments", and "social impact". CONCLUSIONS Clinical and scientific efforts to further understand and address concerns about speech, personal presentation, and identity among those diagnosed with oral tongue are important to improving care processes and patient-centered experience.
Collapse
Affiliation(s)
| | - Sarah H Kagan
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|