Dysphagia

Maurer, Julia; Hipp, Matthias; Schäfer, C.; Kölbl, Oliver

doi:10.1007/s00066-011-2275-x

Cited by 66 publications

(22 citation statements)

References 37 publications

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“…(2011) 29 investigaram o impacto da disfagia na QV de 35 pacientes com carcinoma de células escamosas localmente avançado na região de cabeça e pescoço. Destes, 80% recebeu quimioterapia concomitante.…”

Section: Disfagia E Câncerunclassified

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Qualidade De Vida Em Deglutição E Câncer De Cabeça E Pescoço: Revisão De Literatura

Carrera¹,

Medrado²,

Martins³

et al. 2017

RevBahianaOdonto

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| Objective:This study aimed to review the literature on the quality of life related to swallowing of patients with head and neck cancer. Methods: We searched for studies describing the physiology of swallowing and aspects involved in dysphagia, such as definition, causes and their impact on quality of life. We used the electronic databases Pubmed, Medline, Scielo, books, as well as articles identified in the references. Results: Deglutition disorders may occur due to disease and / or treatment modality, persisting during or after termination of treatment. The frequency and severity of dysphagia will depend on the modality of treatment used, location and stage of the tumor, when involved in structures that participate in swallowing. Patients with tumors in more advanced stages and located in the pharynx try to present worsening of swallowing function. Such factors may directly affect swallowing and quality of life of the patient, especially in family, social and lifestyle relationships. Conclusion: Although it does not replace clinical and instrumental evaluations, investigating the quality of life in swallowing may contribute to assess specific aspects of patient well-being that are not contemplated.Keywords: Quality of life; Swallowing; Head and Neck Cancer; Dysphagia. RESUMO | Objetivo:O estudo teve como objetivo revisar a literatura a respeito da qualidade de vida relacionada à deglutição de pacientes com câncer de cabeça e pescoço. Métodos: Buscou-se estudos relatando a fisiologia da deglutição e os aspectos envolvidos na disfagia, como definição, causas e seu impacto na qualidade de vida. Foram utilizados os bancos de dados eletrônicos Pubmed, Medline, Scielo, livros, assim como de artigos identificados nas referências. Resultados: Distúrbios da deglutição podem ocorrer devido à doença e/ou modalidade de tratamento, persistindo durante ou após o término do tratamento. A frequência e gravidade da disfagia dependerão da modalidade de tratamento utilizada, localização e estágio do tumor, quando envolvidos em estruturas que participem da deglutição. Pacientes com tumores em estágios mais avançados e localizados na faringe tendem a apresentar piora na função da deglutição. Tais fatores poderão interferir diretamente na deglutição e qualidade de vida do paciente, sobretudo nas relações familiares, sociais e no estilo de vida. Conclusão: Apesar de não substituir as avaliações clínicas e instrumentais, investigar a qualidade de vida em deglutição pode contribuir para avaliar aspectos específicos sobre o bem-estar do paciente que não são contemplados nestas avaliações.

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Section: Disfagia E Câncerunclassified

“…Doze meses após o fim do tratamento, 15% ainda sofria deste sintoma. Observou-se maiores complicações alimentares nos pacientes que foram submetidos à quimioterapia concomitante, aumentando a incidência e a gravidade da disfagia 29 .…”

Section: Considerações Finaisunclassified

Qualidade De Vida Em Deglutição E Câncer De Cabeça E Pescoço: Revisão De Literatura

Carrera¹,

Medrado²,

Martins³

et al. 2017

RevBahianaOdonto

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“…The raw weekly toxicity incidence data reported by Van Der Laan et al (2015) indicated a symptom peak for oral mucositis, xerostomia, tube feeding use, and need for liquid diets in patients final week of treatment. Maurer, Hipp, Schäfer, and Kölbl (2011) also reported details of the pattern of dysphagia, mucositis, and xerostomia in their study of 35 patients with HNC undergoing intensity modulated arc therapy +/-chemotherapy. They found the incidence of grade 2-3 xerostomia, dysphagia and mucositis peaked from week 4 (xerostomia and dysphagia) and week 5 (mucositis) of treatment with a significant decrease in mucositis and dysphagia symptoms by 6 weeks post-treatment and a return to baseline dysphagia after 6 months.…”

Section: Acute Toxicities Associated With Non-surgical Treatment a Bmentioning

confidence: 99%

“…As previously discussed, late toxicities can either be acute toxicities that persist beyond the first 3 months posttreatment or side effects of treatment that first present after the acute care phase and are described above in Table 1.2. Late toxicities can continue for months, years, or indefinitely, and understandably greatly impact the QOL of patients with HNC (Chundury et al, 2015;Ganzer et al, 2015;Maurer et al, 2011;Nund et al, 2014b;Roe et al, 2014). Meta-analysis has shown that while global QOL is recovered by 12 months post-treatment, a number of issues persist after non-surgical treatment, such as difficulties with xerostomia, sticky saliva, social eating issues, fatigue, and deterioration in physical function continuing at 12 months post-treatment (So et al, 2012).…”

Section: Late Toxicities Associated With Non-surgical Treatmentmentioning

confidence: 99%

“…Although this model provided an improved, coordinated pathway of care compared to the previous model of care in that service, it is unknown if this level of intensive support was critical for the outcomes achieved. Interestingly, the scheduled reviews in that pathway were not conducted in the last weeks of treatment or in the first month post-treatment when symptoms have been reported to peak (Cartmill, Cornwell, Ward, Davidson, & Porceddu, 2013;Maurer et al, 2011;Van Der Laan et al, 2015). In addition, the authors note that sustaining such a complex pathway requires extensive staff resources, financial investment and perseverance with communication (Messing et al, 2019).…”

Section: A Call For "Research Informed" Speech Pathology Service Delimentioning

confidence: 99%

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Dysphagia and related toxicity in patients with head and neck cancer receiving helical intensity modulated radiotherapy +/- chemotherapy: Implications for speech pathology management

Moroney¹

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The management of head and neck cancer (HNC) using radiotherapy +/-chemotherapy (C)RT is associated with significant morbidity, due to key structures required for speech, swallowing, respiration, and voice falling within the treatment field. Common sequelae of non-surgical treatment include a wide range of toxicities, though dysphagia (swallowing difficulty) is particularly prominent. Dysphagia may be a short-term acute toxicity, or persist long-term, and can have a significant negative impact on quality of life. With recent advancements in technology, new conformal radiotherapy techniques such as helical intensity modulated radiotherapy (H-IMRT) have been introduced into clinical practice. Such techniques offer potential to limit the radiation exposure to non-cancerous normal tissues, and potentially reduce associated treatment toxicities -whilst maintaining cure rates. However as yet, there is limited literature documenting the incidence, severity, and pattern of treatment related toxicities, including dysphagia, associated with H-IMRT +/-chemotherapy, to support if such improvements for the patient are realised. Understanding how patients are impacted by new treatment approaches is crucial information for speech pathology services, that manage the dysphagia and related toxicities of patients. Therefore, the overall objective of this thesis was to evaluate the incidence and severity of dysphagia and related toxicities of patients undergoing H-IMRT +/-chemotherapy to inform speech pathology management practices. A secondary objective was to use this information to develop, and then evaluate a new clinical pathway of care. These objectives were addressed in a series of 4 studies.Study 1 (Chapter 2) prospectively examined the range of dysphagia and related toxicities from baseline to 12 weeks post H-IMRT +/-chemotherapy for a heterogeneous cohort of patients with mixed tumour sites and stages. A high proportion of patients were found to continue to experience grade 2-3 toxicity that peaked in the final week of treatment. Symptoms consistently improved thereafter, with the majority better than baseline by 12 weeks post-treatment.Concurrent chemotherapy at least doubled the odds of experiencing most symptoms. The findings of Chapter 2 confirmed that despite advancements in radiotherapy technique, patients iv The findings, clinical implications, limitations, and future areas of research are discussed in Chapter 6 of this thesis. In conclusion, this thesis provides information detailing the incidence, severity, and temporal pattern of dysphagia and related toxicities experienced by patients with HNC undergoing H-IMRT +/-chemotherapy to optimise supportive care and enhance patient education. These findings can be used to inform the timing and intensity of patient centred speech pathology service delivery models that meet the specific needs of patient subgroups and can form the basis of future guidelines for speech pathology support. v

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Risk factors for late dysphagia after (chemo)radiotherapy for head and neck cancer: A systematic methodological review

Jiang

Zhang

et al. 2015

Head & Neck

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Dysphagia

Cited by 66 publications

References 37 publications

Qualidade De Vida Em Deglutição E Câncer De Cabeça E Pescoço: Revisão De Literatura

Qualidade De Vida Em Deglutição E Câncer De Cabeça E Pescoço: Revisão De Literatura

Dysphagia and related toxicity in patients with head and neck cancer receiving helical intensity modulated radiotherapy +/- chemotherapy: Implications for speech pathology management

Risk factors for late dysphagia after (chemo)radiotherapy for head and neck cancer: A systematic methodological review

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