본문 바로가기
KERD
논문KCI 등재

Rick Factors Associated with Aspiration in Patients with Head and Neck Cancer

2

조회

0

다운로드

3

인용

0

참고문헌

키워드

주제분류재활의학

초록

Objective To determine the major risk factors and abnormal videofl uoroscopic swallowing study (VFSS) fi ndings associated with aspiration in patients with head and neck cancer (HNC). Method Risk factors associated with aspiration were investigated retrospectively in 241 patients with HNC using medical records and pre-recorded VFSS. Age, gender, lesion location and stage, treatment factors, and swallowing stage abnormalities were included. Results Aspiration occurred in 50.2% of patients. A univariate analysis revealed that advanced age, increased duration from disease onset to VFSS, higher tumor stage, increased lymph node stage, increased American Joint Committee on Cancer (AJCC) stage, operation history, chemotherapy history, and radiotherapy history were significantly associated with aspiration (p<0.05). Among them, advanced age, increase AJCC stage, operation history, and chemotherapy history were significantly associated with aspiration in the multivariate analysis (p<0.05). Delayed swallowing reflex and reduced elevation of the larynx were significantly associated with aspiration in the multivariate analysis (p<0.05). Conclusion The major risk factors associated with aspiration in patients with HNC were advanced age, higher AJCC stage, operation history, and chemotherapy history. A VFSS to evaluate aspiration is needed in patients with NHC who have these risk factors. Delayed swallowing reflex and reduced elevation of the larynx were major abnormal findings associated with aspiration. Dysphagia rehabilitation should focus on these results.

Abstract

Objective To determine the major risk factors and abnormal videofl uoroscopic swallowing study (VFSS) fi ndings associated with aspiration in patients with head and neck cancer (HNC). Method Risk factors associated with aspiration were investigated retrospectively in 241 patients with HNC using medical records and pre-recorded VFSS. Age, gender, lesion location and stage, treatment factors, and swallowing stage abnormalities were included. Results Aspiration occurred in 50.2% of patients. A univariate analysis revealed that advanced age, increased duration from disease onset to VFSS, higher tumor stage, increased lymph node stage, increased American Joint Committee on Cancer (AJCC) stage, operation history, chemotherapy history, and radiotherapy history were significantly associated with aspiration (p<0.05). Among them, advanced age, increase AJCC stage, operation history, and chemotherapy history were significantly associated with aspiration in the multivariate analysis (p<0.05). Delayed swallowing reflex and reduced elevation of the larynx were significantly associated with aspiration in the multivariate analysis (p<0.05). Conclusion The major risk factors associated with aspiration in patients with HNC were advanced age, higher AJCC stage, operation history, and chemotherapy history. A VFSS to evaluate aspiration is needed in patients with NHC who have these risk factors. Delayed swallowing reflex and reduced elevation of the larynx were major abnormal findings associated with aspiration. Dysphagia rehabilitation should focus on these results.

참고문헌 (38)

  1. Nguyen NP, "Aspiration rate following chemoradiation for head and neck cancer: an underreported occurrence", Radiother Oncol, 80, pp.302~306 (2006)
  2. Nguyen NP, "Dysphagia following chemoradiation for locally advanced head and neck cancer", Ann Oncol, 15, pp.383~388 (2004)
  3. Kotz T, "Swallowing dysfunction after chemoradiation for advanced squamous cell carcinoma of the head and neck", Head Neck, 26, pp.365~372 (2004)
  4. Carrara-de Angelis E, "Voice and swallowing in patients enrolled in a larynx preservation trial", Arch Otolaryngol Head Neck Surg, 129, pp.733~738 (2003)
  5. Steiniger JR, "Morbidity of combined therapy for the treatment of supraglottic carcinoma: supraglottic laryngectomy and radiotherapy", Ann Otol Rhinol Laryngol, 106, pp.151~158 (1997)
  6. Eisbruch A, "Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head-and-neck cancer", Int J Radiat Oncol Biol Phys, 53, pp.23~28 (2002)
  7. Langerman A, "Aspiration in chemoradiated patients with head and neck cancer", Arch Otolaryngol Head Neck Surg, 133, pp.1289~1295 (2007)
  8. Wu CH, "Dysphagia after radiotherapy: endoscopic examination of swallowing in patients with nasopharyngeal carcinoma", Ann Otol Rhinol Laryngol, 109, pp.320~325 (2000)
  9. Hughes PJ, "Dysphagia in treated nasopharyngeal cancer", Head Neck, 22, pp.393~397 (2000)
  10. Nguyen NP, "Impact of swallowing therapy on aspiration rate following treatment for locally advanced head and neck cancer", Oral Oncol, 43, pp.352~357 (2007)
  11. Bernal-Sprekelsen M, "Predictive values for aspiration after endoscopic laser resections of malignant tumors of the hypopharynx and larynx", Head Neck, 26, pp.103~110 (2004)
  12. Lazarus CL, "Swallowing disorders in head and neck cancer patients treated with radiotherapy and adjuvant chemotherapy", Laryngoscope, 106, pp.1157~1166 (1996)
  13. Stenson KM, "Swallowing function in patients with head and neck cancer prior to treatment", Arch Otolaryngol Head Neck Surg, 126, pp.371~377 (2000)
  14. Humphreys B, "Videofluoroscopic and scintigraphic analysis of dysphagia in the head and neck cancer patient", Laryngoscope, 97, pp.25~32 (1987)
  15. Karnell M, "Swallowing function following multispecialty organ preservation treatment of advanced head and neck-cancer", Oncol Rep, 1, pp.597~601 (1994)
  16. Edge SB, "AJCC cancer staging manual (electronic resource), 7th ed", pp.15~67 (2010), Springer
  17. Pannunzio TG, "Aspiration of oral feedings in patients with tracheostomies", AACN Clin Issues, 7, pp.560~569 (1996)
  18. Starmer H, "Pretreatment swallowing assessment in head and neck cancer patients", Laryngoscope, 121, pp.1208~1211 (2011)
  19. Petterson JM, "Th e clinical application of the 100mL water swallow test in head and neck cancer", Oral Oncol, 47, pp.180~184 (2011)
  20. Caudell JJ, "Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced headand- neck cancer", Int J Radiat Oncol Biol Phys, 73, pp.410~415 (2009)
  21. Logemann JA, "Site of disease and treatment protocol as correlates of swallowing func tion in patients with head and neck cancer treated with chemoradiation", Head Neck, 28, pp.64~73 (2006)
  22. Smith RV, "Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea: initial results", Arch Otolaryngol Head Neck Surg, 126, pp.384~389 (2000)
  23. Kikawada M, "Aspiration and infection in the elderly: epidemiology, diagnosis and management", Drugs Aging, 22, pp.115~130 (2005)
  24. Bloem BR, "Prevalence of subjective dysphagia in community residents aged over 87", BMJ, 300, pp.721~722 (1990)
  25. Logemann JA, "Swallowing disorders in the fi rst year after radiation and chemoradiation", Head Neck, 30, pp.148~158 (2008)
  26. Campbell BH, "Aspiration, weight loss, and quality of life in head and neck cancer survivors", Arch Otolaryngol Head Neck Surg, 130, pp.1100~1103 (2004)
  27. Chapuy CI, "Swallowing function following postchemoradiotherapy neck dissection: review of findings and analysis of contributing factors", Otolaryngol Head Neck Surg, 145, pp.428~434 (2011)
  28. Nguyen NP, "Analysis of factors infl uencing aspiration risk following chemoradiation for oropharyngeal cancer", Br J Radiol, 82, pp.675~680 (2009)
  29. Weber RS, "Functional results after total or near total glossectomy with laryngeal preservation", Arch Otolaryngol Head Neck Surg, 117, pp.512~515 (1991)
  30. McConnel FM, "Manofluorography of deglutition after supraglottic laryngectomy", Head Neck Surg, 9, pp.142~150 (1987)
  31. Kronenberger MB, "Dysphagia following head and neck cancer surgery", Dysphagia, 9, pp.236~244 (1994)
  32. Lango MN, "Impact of neck dissection on long-term feeding tube dependence in patients with head and neck cancer treated with primary radiation or chemoradiation", Head Neck, 32, pp.341~347 (2010)
  33. Nguyen NP, "Dysphagia severity following chemoradiation and postoperative radiation for head and neck cancer", Eur J Radiol, 59, pp.453~459 (2006)
  34. Gaziano JE, "Evaluation and management of oropharyngeal dysphagia in head and neck cancer", Cancer control, 9, pp.400~409 (2002)
  35. Pauloski BR, "Impact of tongue base and posterior pharyngeal wall biomechanics on pharyngeal clearance in irradiated postsurgical oral and oropharyngeal cancer patients", Head Neck, 22, pp.120~131 (2000)
  36. Wu CH, "Dysphagia after radiotherapy: endoscopic examination of swallowing in patients with nasopharyngeal carcinoma", Ann Otol Rhinol Laryngol, 109, pp.320~325 (2000)
  37. Galli J, "Postoperative dysphagia versus Neurogenic dysphagia: scintigraphic assessment", Ann Otol Rhinol Laryngol, 112, pp.20~28 (2003)
  38. Logemann JA, "Swallowing disorders in three types of head and neck surgical patients", Cancer, 44, pp.1095~1105 (1979)

관련 논문AI추천

이 간행물의 다른 논문 (11건)