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Bhat B, Balasubramanium RK, Krishnamurthy R, Rinkel RNMP. Validation and Psychometric Evaluation of the Kannada Version of the Speech Handicap Index in Individuals with Oral and Oropharyngeal Cancer. Indian J Otolaryngol Head Neck Surg 2022; 74:5019-5027. [PMID: 36742590 PMCID: PMC9895559 DOI: 10.1007/s12070-021-02645-2] [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: 04/24/2021] [Accepted: 05/17/2021] [Indexed: 02/07/2023] Open
Abstract
The current study aimed to adapt and validate the speech handicap index into the Kannada language, and also to investigate its psychometric properties in Kannada speaking individuals with oral and oropharyngeal cancers. This is a cross-sectional study and it was carried out in two phases. The first phase dealt with the translation of the English version of SHI into the Kannada language, and its validation on 95 healthy individuals and 25 individuals with oral or oropharyngeal cancer. The second phase dealt with the investigation of speech-related quality of life among 50 Kannada speaking individuals with oral and oropharyngeal cancers. The SHI-K has very good internal consistency (Cronbach's Alpha is 0.98) and exhibited good test-retest reliability (ICC = 0.94). The mean scores of the disordered group, for the psychosocial scores (t (118) = 25.87, p < 0.01), for speech scores (t (118) = 19.74, p < 0.01), for total SHI scores (t (188) = 26.45, p < 0.01), for overall rating (t (118) = 16.81, p < 0.01) were statistically significant and greater than the healthy group (p < 0.01). A statistically significant association was found between clinical-stage, total SHI scores, and rating [χ2 (4, N = 50) = 3.82, p = 0.02], but not for sex, tumor site, and type of treatment received. SHI-K is a valid and reliable tool to assess the speech-related quality of life of individuals with speech disorders. This tool can allow clinicians to plan better rehabilitation, and it can be used as an outcome tool for any treatment studies. The findings of the study emphasize the importance of considering patient priorities before commencing surgical or therapeutic interventions.
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Affiliation(s)
- Bhavana Bhat
- Department of Audiology and Speech Language Pathology, Manipal Academy of Higher Education, Kasturba Medical College, Mangalore, Manipal, Karnataka India
| | - Radish Kumar Balasubramanium
- Department of Audiology and Speech Language Pathology, Manipal Academy of Higher Education, Kasturba Medical College, Mangalore, Manipal, Karnataka India
| | - Rahul Krishnamurthy
- Department of Audiology and Speech Language Pathology, Manipal Academy of Higher Education, Kasturba Medical College, Mangalore, Manipal, Karnataka India
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Woisard V, Balaguer M, Fredouille C, Farinas J, Ghio A, Lalain M, Puech M, Astesano C, Pinquier J, Lepage B. Construction of an automatic score for the evaluation of speech disorders among patients treated for a cancer of the oral cavity or the oropharynx: The Carcinologic Speech Severity Index. Head Neck 2021; 44:71-88. [PMID: 34729847 DOI: 10.1002/hed.26903] [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: 10/25/2020] [Revised: 08/15/2021] [Accepted: 10/05/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Speech disorders impact quality of life for patients treated with oral cavity and oropharynx cancers. However, there is a lack of uniform and applicable methods for measuring the impact on speech production after treatment in this tumor location. OBJECTIVE The objective of this work is to (1) model an automatic severity index of speech applicable in clinical practice, that is equivalent or superior to a severity score obtained by human listeners, via several acoustics parameters extracted (a) directly from speech signal and (b) resulting from speech processing and (2) derive an automatic speech intelligibility classification (i.e., mild, moderate, severe) to predict speech disability and handicap by combining the listener comprehension score with self-reported quality of life related to speech. METHODS Eighty-seven patients treated for cancer of the oral cavity or the oropharynx and 35 controls performed different tasks of speech production and completed questionnaires on speech-related quality of life. The audio recordings were then evaluated by human perception and automatic speech processing. Then, a score was developed through a classic logistic regression model allowing description of the severity of patients' speech disorders. RESULTS Among the group of parameters subject to extraction from automatic processing of the speech signal, six were retained, producing a correlation at 0.87 with the perceptual reference score, 0.77 with the comprehension score, and 0.5 with speech-related quality of life. The parameters that contributed the most are based on automatic speech recognition systems. These are mainly the automatic average normalized likelihood score on a text reading task and the score of cumulative rankings on pseudowords. The reduced automatic YC2SI is modeled in this way: YC2SIp = 11.48726 + (1.52926 × Xaveraged normalized likelihood reading ) + (-1.94e-06 × Xscore of cumulative ranks pseudowords ). CONCLUSION Automatic processing of speech makes it possible to arrive at valid, reliable, and reproducible parameters able to serve as references in the framework of follow-up of patients treated for cancer of the oral cavity or the oropharynx.
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Affiliation(s)
- Virginie Woisard
- ENT Department, University Hospital of Toulouse, Toulouse, France.,Oncorehabilation Unit, University Institute of Cancer of Toulouse Oncopole, Toulouse, France.,Laboratoire Octogone-Lordat, Jean Jaures University Toulouse II, Toulouse, France
| | - Mathieu Balaguer
- ENT Department, University Hospital of Toulouse, Toulouse, France.,Institut de Recherche en Informatique de Toulouse, CNRS, Paul Sabatier University Toulouse III, Toulouse, France
| | - Corinne Fredouille
- Laboratoire d'Informatique d'Avignon, Avignon University, Avignon, France
| | - Jérôme Farinas
- Oncorehabilation Unit, University Institute of Cancer of Toulouse Oncopole, Toulouse, France
| | - Alain Ghio
- Laboratoire Parole et Langage, Aix-Marseille University, Marseille, France
| | - Muriel Lalain
- Laboratoire Parole et Langage, Aix-Marseille University, Marseille, France
| | - Michèle Puech
- ENT Department, University Hospital of Toulouse, Toulouse, France.,Oncorehabilation Unit, University Institute of Cancer of Toulouse Oncopole, Toulouse, France
| | - Corine Astesano
- Laboratoire Octogone-Lordat, Jean Jaures University Toulouse II, Toulouse, France
| | - Julien Pinquier
- Oncorehabilation Unit, University Institute of Cancer of Toulouse Oncopole, Toulouse, France
| | - Benoît Lepage
- ENT Department, University Hospital of Toulouse, Toulouse, France.,USMR, Université Paul Sabatier Toulouse III, Toulouse, France
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Xiao Y, Wang T, Deng W, Yang L, Zeng B, Lao X, Zhang S, Liu X, Ouyang D, Liao G, Liang Y. Data mining of an acoustic biomarker in tongue cancers and its clinical validation. Cancer Med 2021; 10:3822-3835. [PMID: 33938165 PMCID: PMC8178493 DOI: 10.1002/cam4.3872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 01/30/2021] [Accepted: 03/14/2021] [Indexed: 11/08/2022] Open
Abstract
The promise of speech disorders as biomarkers in clinical examination has been identified in a broad spectrum of neurodegenerative diseases. However, to the best of our knowledge, a validated acoustic marker with established discriminative and evaluative properties has not yet been developed for oral tongue cancers. Here we cross-sectionally collected a screening dataset that included acoustic parameters extracted from 3 sustained vowels /ɑ/, /i/, /u/ and binary perceptual outcomes from 12 consonant-vowel syllables. We used a support vector machine with linear kernel function within this dataset to identify the formant centralization ratio (FCR) as a dominant predictor of different perceptual outcomes across gender and syllable. The Acoustic analysis, Perceptual evaluation and Quality of Life assessment (APeQoL) was used to validate the FCR in 33 patients with primary resectable oral tongue cancers. Measurements were taken before (pre-op) and four to six weeks after (post-op) surgery. The speech handicap index (SHI), a speech-specific questionnaire, was also administrated at these time points. Pre-op correlation analysis within the APeQoL revealed overall consistency and a strong correlation between FCR and SHI scores. FCRs also increased significantly with increasing T classification pre-operatively, especially for women. Longitudinally, the main effects of T classification, the extent of resection, and their interaction effects with time (pre-op vs. post-op) on FCRs were all significant. For pre-operative FCR, after merging the two datasets, a cut-off value of 0.970 produced an AUC of 0.861 (95% confidence interval: 0.785-0.938) for T3-4 patients. In sum, this study determined that FCR is an acoustic marker with the potential to detect disease and related speech function in oral tongue cancers. These are preliminary findings that need to be replicated in longitudinal studies and/or larger cohorts.
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Affiliation(s)
- Yudong Xiao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Tao Wang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Wei Deng
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Le Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Bin Zeng
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Xiaomei Lao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Sien Zhang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Xiangqi Liu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Daiqiao Ouyang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Guiqing Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yujie Liang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
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Menezes ASDS, Sanches GLG, Gomes ESB, Soares RG, Durães CP, Fonseca LL, Filho ADPS, Ribeiro AAADA, Nascimento JE, Santos SHS, de Paula AMB, Farias LC, Guimarães ALS. The combination of traditional and auricular acupuncture to prevent xerostomia and anxiety in irradiated patients with HNSCC: a preventive, parallel, single-blind, 2-arm controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:675-683. [PMID: 33839061 DOI: 10.1016/j.oooo.2021.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/16/2021] [Accepted: 02/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the effect of acupuncture on xerostomia in irradiated patients with head and neck squamous cell carcinoma (HNSCC). STUDY DESIGN A preventive, 2-arm, parallel, single-blind trial was performed. Patients with HNSCC (N = 296) were checked for eligibility, and 107 patients were enrolled in the study. The study comprised 1 group that did not receive the intervention (n = 55) and the interventional group that received traditional and auricular acupuncture (n = 52). The primary outcome was the reduction of the patients' xerostomia after treatment. In addition, the secondary outcome was the reduction of anxiety. RESULTS The current acupuncture protocol reduced the xerostomia score and increased saliva volume and density without changing salivary pH. Additionally, acupuncture decreased the Beck Anxiety Inventory (BAI) score after radiation therapy. CONCLUSION Combining traditional and auricular acupuncture reduced xerostomia and increased saliva volume without changing the saliva's pH in irradiated patients with HNSCC. Additionally, the combination of traditional and auricular acupuncture reduced BAI scores.
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Affiliation(s)
| | | | | | - Raquel Gusmão Soares
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Cristina Paixão Durães
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Larissa Lopes Fonseca
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | | | | | | | | | - Lucyana Conceição Farias
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - André Luiz Sena Guimarães
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil; Dilson Godinho Hospital, Montes Claros, Minas Gerais, Brazil.
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Balaguer M, Champenois M, Farinas J, Pinquier J, Woisard V. The (head and neck) carcinologic handicap index: validation of a modular type questionnaire and its ability to prioritise patients' needs. Eur Arch Otorhinolaryngol 2020; 278:1159-1169. [PMID: 32666294 DOI: 10.1007/s00405-020-06201-6] [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: 05/08/2020] [Accepted: 07/07/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To validate the upgraded version of the CHI with two new dimensions ("limitation of neck and/or shoulder movements", "changes in physical appearance"). To assess the relationship between CHI scores and patient self-reported management needs. METHODS 71 patients treated for cancer with ENT complaints and 36 controls were included. Construct validity, internal consistency, criterion validity (using visual analogue scales by dimension), clinical validity (comparison of patient and control scores) and temporal reliability (scores of a second CHI completed after a few days) were studied. A hierarchical ranking of the dimensions according to perceived difficulties was compared to the CHI scores. RESULTS Correlations were moderate to high between items of the same dimension (0.38 < r<0.73), between scores on the two new dimensions and on the VAS (r > 0.68), and between scores on the two CHI completions (r > 0.67). Cronbach's alphas are greater than 0.72. Patients and controls had significantly different scores in the two new dimensions (Mann-Whitney: p < 0.001). Sensitivity, specificity and AUC calculated between CHI scores and hierarchy ranking determined patient priority cut-off scores for eight of the eleven dimensions. CONCLUSION The new CHI dimensions have good psychometric qualities. Threshold scores by dimension allow the perceived management needs to be determined.
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Affiliation(s)
- Mathieu Balaguer
- CHU Larrey, Toulouse, France. .,IIRIT, CNRS, Université Paul Sabatier, Toulouse, France.
| | - Maëlle Champenois
- Faculté de Médecine Toulouse Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France
| | | | | | - Virginie Woisard
- CHU Larrey, Toulouse, France.,Laboratoire Octogone-Lordat, Toulouse, France
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Balaguer M, Pommée T, Farinas J, Pinquier J, Woisard V, Speyer R. Effects of oral and oropharyngeal cancer on speech intelligibility using acoustic analysis: Systematic review. Head Neck 2019; 42:111-130. [PMID: 31571334 DOI: 10.1002/hed.25949] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/06/2019] [Accepted: 08/26/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The development of automatic tools based on acoustic analysis allows to overcome the limitations of perceptual assessment for patients with head and neck cancer. The aim of this study is to provide a systematic review of literature describing the effects of oral and oropharyngeal cancer on speech intelligibility using acoustic analysis. METHODS Two databases (PubMed and Embase) were surveyed. The selection process, according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, led to a final set of 22 articles. RESULTS Nasalance is studied mainly in oropharyngeal patients. The vowels are mostly studied using formant analysis and vowel space area, the consonants by means of spectral moments with specific parameters according to their phonetic characteristic. Machine learning methods allow classifying "intelligible" or "unintelligible" speech for T3 or T4 tumors. CONCLUSIONS The development of comprehensive models combining different acoustic measures would allow a better consideration of the functional impact of the speech disorder.
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Affiliation(s)
- Mathieu Balaguer
- CHU Larrey, Toulouse, France.,IRIT, CNRS, Université Paul Sabatier, Toulouse, France
| | | | | | | | - Virginie Woisard
- CHU Larrey, Toulouse, France.,Laboratoire Octogone-Lordat, Toulouse, France
| | - Renée Speyer
- Faculty of Educational Sciences, University of Oslo, Oslo, Norway
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7
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Balaguer M, Boisguerin A, Galtier A, Gaillard N, Puech M, Woisard V. Factors influencing intelligibility and severity of chronic speech disorders of patients treated for oral or oropharyngeal cancer. Eur Arch Otorhinolaryngol 2019; 276:1767-1774. [PMID: 30919058 DOI: 10.1007/s00405-019-05397-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 03/18/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Oral or oropharyngeal tumors degrade patients' speech quality because of their location. The treatment of these cancers also affects the functional outcomes, depending on type (surgery, radiotherapy, chemotherapy), volume resection (according the size of the tumor) or on the anatomical area treated, and the post-treatment delay. The aim of this work is to determine the factors influencing the chronic speech disorders (in terms of intelligibility and severity) of patients treated for an oral or oropharyngeal cancer. METHODS Speech-perceptive assessment was led by a panel of six expert speech therapists, on a task of a description of a picture, presented to 87 patients. Clinical and treatment data were gathered by examining medical files. RESULTS Intelligibility and severity scores in our population were 6.06 (interquartile range 4.2-8) and 7.61 (interquartile range 6.8-9.5) on a maximum of 10. After adjusting for age and anatomical region involved, multivariate analysis showed a principal impact of surgery on both intelligibility and severity, while the size of the tumor significantly affected the intelligibility score [- 143; 95% CI (- 2.21, - 0.65)]. These results are consistent with the definitions of intelligibility and severity of speech disorders. CONCLUSIONS The lack of information on the impact of tumor location, however, requires more work to contribute to reducing impact on the quality of life of patients.
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Affiliation(s)
- Mathieu Balaguer
- Hôpitaux de Toulouse - Hôpital Larrey, Unité de la Voix et de la Déglutition / CCF, 24 chemin de Pouvourville, TSA 30030, 31059, Toulouse Cedex 9, France. .,IRIT, CNRS, University of Toulouse, Toulouse, France.
| | - Aline Boisguerin
- Hôpitaux de Toulouse - Hôpital Larrey, Unité de la Voix et de la Déglutition / CCF, 24 chemin de Pouvourville, TSA 30030, 31059, Toulouse Cedex 9, France
| | - Anaïs Galtier
- Hôpitaux de Toulouse - Hôpital Larrey, Unité de la Voix et de la Déglutition / CCF, 24 chemin de Pouvourville, TSA 30030, 31059, Toulouse Cedex 9, France
| | - Nadège Gaillard
- Hôpitaux de Toulouse - Hôpital Larrey, Unité de la Voix et de la Déglutition / CCF, 24 chemin de Pouvourville, TSA 30030, 31059, Toulouse Cedex 9, France
| | - Michèle Puech
- Hôpitaux de Toulouse - Hôpital Larrey, Unité de la Voix et de la Déglutition / CCF, 24 chemin de Pouvourville, TSA 30030, 31059, Toulouse Cedex 9, France.,Oncopole, Toulouse, France
| | - Virginie Woisard
- Hôpitaux de Toulouse - Hôpital Larrey, Unité de la Voix et de la Déglutition / CCF, 24 chemin de Pouvourville, TSA 30030, 31059, Toulouse Cedex 9, France.,Oncopole, Toulouse, France.,Octogone-Lordat Interdisciplinary Research Unit (EA 4156), University of Toulouse II-Jean Jaurès, Toulouse, France
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Stelzle F, Oetter N, Goellner LT, Adler W, Rohde M, Maier A, Matthies L, Kesting MR, Knipfer C. Speech intelligibility in patients with oral cancer: An objective baseline evaluation of pretreatment function and impairment. Head Neck 2019; 41:1063-1069. [PMID: 30801814 DOI: 10.1002/hed.25527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 08/07/2018] [Accepted: 10/06/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND This study seeks to identify those factors that influence the pre-therapeutic speech intelligibility in patients with oral squamous cell carcinoma (OSCC). METHOD A group of 172 patients (125 males, 47 females, mean age = 61 ± 11 a) with different OSCC stages ranging from T1 to T4 and N0 to N2 was examined for their speech intelligibility using a computerized measuring tool, and compared to a healthy reference group (30 males, 10 females, mean age = 59 ± 12 a). RESULTS It was found that the pre-therapeutic speech intelligibility in patients with OSCC is decreased when compared to a healthy collective. Two demographic factors that influence speech intelligibility could be identified: sex and age. It was determined that the only disease-related factor that influences speech intelligibility before therapy is the location of the tumor. CONCLUSION The results of this study reveal that a preoperative speech intelligibility impairment in patients suffering from OSCC occurs independent of tumor stage, size of the tumor and infiltration status.
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Affiliation(s)
- Florian Stelzle
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Nicolai Oetter
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Luisa Theresa Goellner
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology (IMBE), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Maximilian Rohde
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilian-University Munich, University Hospital Munich, Munich, Germany
| | - Andreas Maier
- Department of Computer Science 5, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Levi Matthies
- Department of Oral and Maxillofacial Surgery, University of Hamburg (UHH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marco Rainer Kesting
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Erlangen, Germany
| | - Christian Knipfer
- Department of Oral and Maxillofacial Surgery, University of Hamburg (UHH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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de Souza MG, de Jesus SF, Santos EM, Gomes ESB, de Paulo Santiago Filho A, Santos EMS, da Silveira LH, Santos SHS, de Paula AMB, Farias LC, Guimarães ALS. Radiation Therapy Reduced Blood Levels of LDH, HIF-1α, and miR-210 in OSCC. Pathol Oncol Res 2018; 26:433-442. [DOI: 10.1007/s12253-018-0517-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 10/25/2018] [Indexed: 12/13/2022]
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Treatment of mucositis with combined 660- and 808-nm-wavelength low-level laser therapy reduced mucositis grade, pain, and use of analgesics: a parallel, single-blind, two-arm controlled study. Lasers Med Sci 2018; 33:1813-1819. [PMID: 29948456 DOI: 10.1007/s10103-018-2549-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/21/2018] [Indexed: 01/09/2023]
Abstract
Oral squamous cell carcinoma (OSCC) is the most frequent oral malignant neoplasia. As consequence of OSCC treatment, oral mucositis (OM) is one of the most common adverse effects of OSCC treatment. Currently, there is no consensus for OM treatment. The purpose of the current study was to test the combination of red and infrared low-level laser therapy (LLLT) for OM treatment. Primary culture of human fibroblast was performed to identify LLLT dose. After laboratory tests, a two-arm parallel, single-blind, controlled study was conducted. The two arms were group 1, both 660- and 808-nm wavelengths (300 J/cm2, 9 J of total energy, 100 mW, spot size 3 mm2), and group 2, only 660-nm wavelength (300 J/cm2, 9 J of total energy, 100 mW, spot size 3 mm2). Both treatments were performed twice a week. Group 1 presented a reduction of mucositis grade in comparison to group 2. Group 1 also presented reduction of analgesics prescription. But no significant differences between groups 1 and 2 were observed according to the pain scale. In conclusion, the current study demonstrated that a combination of red and infrared at a higher dose (300 J/cm2) reduced both oral mucositis grade and analgesics prescription. The effects of the combination of RT and LLLT are unclear and need more studies.
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Guimarães TA, Farias LC, Santos ES, de Carvalho Fraga CA, Orsini LA, de Freitas Teles L, Feltenberger JD, de Jesus SF, de Souza MG, Santos SHS, de Paula AMB, Gomez RS, Guimarães ALS. Metformin increases PDH and suppresses HIF-1α under hypoxic conditions and induces cell death in oral squamous cell carcinoma. Oncotarget 2018; 7:55057-55068. [PMID: 27474170 PMCID: PMC5342401 DOI: 10.18632/oncotarget.10842] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/09/2016] [Indexed: 01/18/2023] Open
Abstract
Background Metformin is a biguanide, belonging to the oral hypoglycemic agents and is a widely used in the treatment of type 2 diabetes. Evidence indicate that Metformin inhibits cell proliferation in several human cancers and inhibits the Warburg phenomenon in tumor cells. Results Low PDH levels were observed in OSCC, and Metformin promotes an increase in PDH levels in hypoxic conditions. Metformin also reduced HIF-1α mRNA and protein levels. Metformin demonstrated antiproliferative effects, inhibited migration, increased the number of apoptotic cells and increased the transcription of caspase 3. Objective The present study aims to explore the effects of Metformin in hypoxic conditions. Specifically, we focused on pyruvate dehydrogenase (PDH), (hypoxia-inducible factor 1α) HIF-1α levels and the oral squamous cell carcinoma (OSCC) cell phenotype. Additionally, we also investigated a theoretical consequence of Metformin treatment. Methods PDH levels in patients with OSCC and oral dysplasia were evaluated. Metformin was administered in vitro to test the effect of Metformin under hypoxic conditions. The results were complemented by Bioinformatics analyses. Conclusions In conclusion, our current findings show that Metformin reduces HIF-1α gene expression and increases PDH expression. Metformin inhibits cell proliferation and migration in the OSCC cell line model. Additionally, Metformin enhances the number of apoptotic cells and caspase 3 levels. Interestingly enough, Metformin did not increase the mutant p53 levels under hypoxic conditions.
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Affiliation(s)
- Talita Antunes Guimarães
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Lucyana Conceição Farias
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Eliane Sobrinho Santos
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil.,Instituto Federal de Educação, Ciência e Tecnologia do Norte de Minas Gerais (IFNMG), Araçuaí, Minas Gerais, Brazil
| | - Carlos Alberto de Carvalho Fraga
- Faculdades Integradas Pitágoras, Montes Claros, Minas Gerais, Brazil.,Faculdades Unidas do Norte de Minas, Montes Claros, Minas Gerais, Brazil
| | - Lissur Azevedo Orsini
- Department of Clinical, Surgery and Oral Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leandro de Freitas Teles
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | - Sabrin Ferreira de Jesus
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | - Sérgio Henrique Sousa Santos
- Institute of Agricultural Sciences, Food Engineering College, Universidade Federal de Minas Gerais (UFMG), Montes Claros, Minas Gerais, Brazil
| | | | - Ricardo Santiago Gomez
- Department of Clinical, Surgery and Oral Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - André Luiz Sena Guimarães
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
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Regular Dental Visits: Influence on Health-Related Quality of Life in 1,607 Patients with Oral Squamous Cell Carcinoma. Int J Dent 2017. [PMID: 28638411 PMCID: PMC5468556 DOI: 10.1155/2017/9638345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background The incidence of oral squamous cell carcinoma (OSCC) is in the top 10 of all cancer entities. Regular oral examinations by dentists play an important role in oral cancer prevention. Methods Patients with OSCC (n = 1,607) and physicians (n = 1,489) completed questionnaires during the DÖSAK Rehab Study. The psychosocial and functional factors collected in these questionnaires were assessed in the present study. We compared patients who visited their dentist at least once a year (group A) with those who visited their dentist less than once a year (group B). Results Patients in group A had significantly better health-related quality of life after tumor treatment than patients in group B. Patients in group A also had a smaller tumor size and less lymph node metastasis and lost fewer teeth during the treatment. This resulted in better prosthetic rehabilitation and better psychological status after tumor treatment. Conclusions Dentists play an important role in the early recognition of oral cancer. This study should encourage dentists to take a more active role in oral cancer prevention.
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Spalthoff S, Zimmerer R, Jehn P, Gellrich NC, Handschel J, Krüskemper G. Neck Dissection's Burden on the Patient: Functional and Psychosocial Aspects in 1,652 Patients With Oral Squamous Cell Carcinomas. J Oral Maxillofac Surg 2016; 75:839-849. [PMID: 27776222 DOI: 10.1016/j.joms.2016.09.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 09/19/2016] [Accepted: 09/20/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE In this study of patients with oral squamous cell carcinoma, the authors sought to clarify the functional and psychosocial harms of neck dissection (ND), which lessens quality of life. MATERIALS AND METHODS The study included questionnaire responses from patients with oral squamous cell carcinoma (n = 1,652) and clinicians (n = 1,489), as collected in the DÖSAK Rehab Study. Psychosocial and functional factors were assessed. Functional and psychosocial outcomes in patients who did not receive ND were compared with those in patients who underwent selective supraomohyoid ND (SND), modified radical ND (MND), and radical ND (RND). RESULTS Patients with ND had lower quality of life than those without ND. Burdens after SND (n = 923) were generally lesser than those after MND (n = 301) or RDN (n = 678). There were meaningful differences between the SND, MND, and RND and without-ND groups in impairments in speech intelligibility for strangers and familiar persons, ingestion and swallowing, tongue mobility, opening of the mouth, lower jaw mobility, neck mobility, and shoulder and arm movement (P < .05). Many patients with ND faced a lower functional status and negative professional and financial consequences. CONCLUSIONS Because of the burdens associated with ND, the decision to perform this treatment for oral squamous cell carcinoma should incorporate information on health-related quality of life and survival rates.
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Affiliation(s)
- Simon Spalthoff
- Consultant, Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
| | - Rüdiger Zimmerer
- Resident, Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Philipp Jehn
- Consultant, Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Nils-Claudius Gellrich
- Professor, Department of Cranio and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Jörg Handschel
- Professor, Department of Cranio and Maxillofacial Surgery, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Gertrud Krüskemper
- Medical Psychologist and Professor, Department of Medical Psychology, Ruhr University of Bochum, Bochum, Germany
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Evaluation of the antineoplastic activity of gallic acid in oral squamous cell carcinoma under hypoxic conditions. Anticancer Drugs 2016; 27:407-16. [PMID: 26849170 DOI: 10.1097/cad.0000000000000342] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of the current study was to develop and test a theoretical model that could explain the mechanism of action of gallic acid (GA) in the oral squamous cell carcinoma context for the first time. The theoretical model was developed using bioinformatics and interaction network analysis to evaluate the effect of GA on oral squamous cell carcinoma. In a second step to confirm theoretical results, migration, invasion, proliferation, and gene expression (Col1A1, E-cadherin, HIF-1α, and caspase-3) were performed under normoxic and hypoxic conditions. Our study indicated that treatment with GA resulted in the inhibition of cell proliferation, migration, and invasion in neoplastic cells. Observation of the molecular mechanism showed that GA upregulates E-cadherin expression and downregulates Col1A1 and HIF-1α expression, suggesting that GA might be a potential anticancer compound. In conclusion, the present study demonstrated that GA significantly reduces cell proliferation, invasion, and migration by increasing E-cadherin and repressing Col1A1.
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Camuzard O, Dassonville O, Ettaiche M, Chamorey E, Poissonnet G, Berguiga R, Leysalle A, Benezery K, Peyrade F, Saada E, Hechema R, Sudaka A, Haudebourg J, Demard F, Santini J, Bozec A. Primary radical ablative surgery and fibula free-flap reconstruction for T4 oral cavity squamous cell carcinoma with mandibular invasion: oncologic and functional results and their predictive factors. Eur Arch Otorhinolaryngol 2016; 274:441-449. [DOI: 10.1007/s00405-016-4219-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/16/2016] [Indexed: 10/21/2022]
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16
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Validity and reliability of the Korean version of the Speech Handicap Index in patients with oral cavity cancer. Int J Oral Maxillofac Surg 2016; 45:433-9. [DOI: 10.1016/j.ijom.2015.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 09/21/2015] [Accepted: 11/11/2015] [Indexed: 11/21/2022]
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17
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Riemann M, Knipfer C, Rohde M, Adler W, Schuster M, Noeth E, Oetter N, Shams N, Neukam FW, Stelzle F. Oral squamous cell carcinoma of the tongue: Prospective and objective speech evaluation of patients undergoing surgical therapy. Head Neck 2015; 38:993-1001. [DOI: 10.1002/hed.23994] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2014] [Indexed: 12/29/2022] Open
Affiliation(s)
- Max Riemann
- Department of Oral and Maxillofacial Surgery; University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU); Erlangen Germany
| | - Christian Knipfer
- Department of Oral and Maxillofacial Surgery; University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU); Erlangen Germany
| | - Maximilian Rohde
- Department of Oral and Maxillofacial Surgery; University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU); Erlangen Germany
| | - Werner Adler
- Department of Medical Informatics; Biometry and Epidemiology; Friedrich-Alexander University Erlangen-Nuremberg (FAU); Erlangen Germany
| | - Maria Schuster
- Department of Otolaryngology; University Hospital of Munich, Ludwig-Maximilians University Munich (LMU); Munich Germany
| | - Elmar Noeth
- Department of Computer Science; Chair of Pattern Recognition; Friedrich-Alexander University Erlangen-Nuremberg (FAU); Erlangen Germany
| | - Nico Oetter
- Department of Oral and Maxillofacial Surgery; University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU); Erlangen Germany
| | - Nima Shams
- Department of Oral and Maxillofacial Surgery; University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU); Erlangen Germany
| | - Friedrich-Wilhelm Neukam
- Department of Oral and Maxillofacial Surgery; University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU); Erlangen Germany
| | - Florian Stelzle
- Department of Oral and Maxillofacial Surgery; University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU); Erlangen Germany
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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.
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Affiliation(s)
| | - Sarah H Kagan
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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