Strahlentherapie und Onkologie

, Volume 187, Issue 1, pp 39–44 | Cite as

A Randomized Prospective Study of Rehabilitation Therapy in the Treatment of Radiation-induced Dysphagia and Trismus

Original Article

Abstract

Purpose:

To evaluate the therapeutic effect of rehabilitation therapy on radiation-induced dysphagia and trismus in nasopharyngeal carcinoma (NPC) patients after radiotherapy.

Patients and Methods:

43 NPC patients after radiotherapy were included. Patients were randomly assigned to either the rehabilitation group or a control group. Both groups were subjected to routine treatment, while the rehabilitation group also received rehabilitation therapy for 3 months. The severity of dysphagia was assessed using the water swallow test, while trismus was evaluated with the LENT/SOMA score and the interincisor distance (IID). The water swallow test, the LENT/SOMA score, as well as IID for both groups before and after treatment were analyzed and compared.

Results:

After treatment, the rehabilitation group displayed a significant improvement in swallowing function, while the control group did not. The efficacy rate (percentage of patients with excellent or effective results) of rehabilitation group was higher than that of control group (77% vs. 43%), and the difference was statistically significant (ϰ2 = 5.32, p = 0.02). IID pretreatment and posttreatment did not show much difference in the rehabilitation group, while in the control group IID significantly decreased posttreatment (1.1 ± 0.36 cm vs.1.8 ± 0.56 cm, p = 0.001). Although the mean IID in patients of both groups decreased after the 3 month follow-up, the decrease in the rehabilitation group was less than that of the control group (0.19 ± 0.5 cm vs. 0.69 ± 0.56 cm, p = 0.004 ). The efficacy rate of trismus in the rehabilitation group was significantly higher than that of the control group (64% vs. 28%, ϰ2 = 5.31, p = 0.02).

Conclusions:

Rehabilitation training can improve swallow function and slow down the progress of trismus in NPC patients following radiotherapy.

Key Words

Nasopharyngeal carcinoma Radiotherapy Dysphagia Trismus Rehabilitation training 

Eine randomisierte Prospektivstudie von Rehabilitation der strahleninduzierten Dysphagie bzw. Trismus

Zusammenfassung

Hintergrund:

Evaluation der therapeutischen Wirkung von Maßnahmen zur Verbesserung der strahleninduzierten Dysphagie bzw. des Trismus bei Patienten mit Nasopharynxkarzinomen (NPL).

Methoden:

43 NPC-Patienten mit Strahlentherapie. Die Patienten wurden randomisiert in die Rehabilitationsgruppe und eine Kontrollgruppe. Beide Gruppen unterzogen sich einer Standardbehandlung, während die Rehabilitationsgruppe zusätzlich 3 Monate lang Maßnahmen zur Befundverbesserung erhielt. Der Schweregrad der Dysphagie wurde mit Hilfe des Wasserschlucktests bewertet, während der Trismus durch den LENT-SOMA Score und den Abstand der Schneidezähne (IID) evaluiert wurde. Der Wasserschlucktest und der LENT-SOMA Score sowie der IID bei beiden Gruppen wurde vor und nach Behandlung analysiert und verglichen.

Ergebnisse:

Nach Behandlung wies die Rehabilitationsgruppe eine deutliche Verbesserung der Schluckfunktion im Vergleich zur Kontrollgruppe auf. Die Effizienz (Prozent der Patienten mit exzellenter oder guter Wieksamkeit) war in der von Rehabilitationsgruppe höher als in der Kontrollgruppe (77% vs. 43%), und der Unterschied war statistisch signifikant (ϰ2 = 5.32, p = 0.02). Die Effizienz bei Trismus war in der Rehabilitationsgruppe maßgeblich höher als in der Kontrollgruppe (64% vs. 28%, ϰ2 = 5.31, p = 0.02). Obwohl sich der Schneidezahnabstand von Patienten in beiden Gruppen verringerte, war die Verringerung in der Rehabilitationsgruppe weniger als der in Kontrollgruppe (0.19 ± 0.5 cm vs. 0.69 ± 0.56 cm, p = 0.004).

Fazit:

Rehabilitationstraining kann die Schluckfunktion verbessern und verlangsamt die Entwicklung des Trismus von NPCPatienten nach Strahlentherapie.

Schlüsselwörter

Nasopharynxkarzinom Strahlentherapie Dysphagie Trismus Rehabilitationstraining 

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Copyright information

© Urban & Vogel, Muenchen 2010

Authors and Affiliations

  • Y. Tang
    • 1
    • 4
  • Q. Shen
    • 1
  • Y. Wang
    • 2
  • K. Lu
    • 1
  • Y. Wang
    • 3
  • Y. Peng
    • 1
    • 4
  1. 1.Department of NeurologySun Yat-Sen Memorial Hospital, Sun Yat-sen UniversityGuangzhouChina
  2. 2.Department of Internal MedicineThe First Affiliated Hospital, Sun Yat-sen UniversityGuangzhouChina
  3. 3.Department of NeurosurgerySun Yat-Sen Memorial Hospital, Sun Yat-sen UniversityGuangzhouChina
  4. 4.Department of NeurologySun Yat-Sen Memorial Hospital, Sun Yat-Sen University No. 107GuangzhouChina

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