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Abstract：
The aim of the study was to examine the following: (a) the trajectory of external and internal head and neck lymphoedema (HNL) in patients with head and neck cancer (HNC) up to 12 months post-chemoradiotherapy (CRT) and (b) the relationship between HNL and swallowing function. Using a prospective longitudinal cohort study, external/internal HNL and swallowing were examined in 33 participants at 3, 6 and 12 months post-CRT. External HNL was assessed using the Assessment of Lymphoedema of the Head and Neck and the MD Anderson Cancer Centre Lymphoedema Rating Scale. Internal HNL was rated using Patterson\'s Radiotherapy Oedema Rating Scale. Swallowing was assessed via clinical, instrumental and patient-reported measures. Associations between HNL and swallowing were examined using multivariable regression models. External HNL was prevalent at 3 months (71%), improved by 6 months (58%) and largely resolved by 12 months (10%). In contrast, moderate/severe internal HNL was prevalent at 3 months (96%), 6 months (84%) and at 12 months (65%). More severe penetration/aspiration and increased diet modification were associated with higher severities of external HNL (p=0.006 and p=0.031, respectively) and internal HNL (p<0.001 and p=0.007, respectively), and more diffuse internal HNL (p=0.043 and p=0.001, respectively). Worse patient-reported swallowing outcomes were associated with a higher severity of external HNL (p=0.001) and more diffuse internal HNL (p=0.002). External HNL largely resolves by 12 months post-CRT, but internal HNL persists. Patients with a higher severity of external and/or internal HNL and those with more diffuse internal HNL can be expected to have more severe dysphagia.
摘要：
该研究的目的是检查以下内容：（a）头颈部癌症（HNC）患者在放化疗（CRT）后12个月内的外部和内部头颈部淋巴水肿（HNL）的轨迹和（b）HNL与吞咽功能之间的关系。使用前瞻性纵向队列研究，在CRT后3,6和12个月时,对33名参与者进行了外部/内部HNL和吞咽检查.使用头颈部淋巴水肿评估和MDAnderson癌症中心淋巴水肿评定量表评估外部HNL。使用Patterson的放射治疗水肿评定量表对内部HNL进行评级。通过临床评估吞咽情况，仪器和患者报告的措施。使用多变量回归模型检查HNL和吞咽之间的关联。外部HNL在3个月时普遍(71%)，改善了6个月（58%），基本解决了12个月（10%）。相比之下,中度/重度内部HNL在3个月时普遍(96%)，6个月（84%）和12个月（65%）。更严重的渗透/误吸和增加的饮食调整与外部HNL（分别为p=0.006和p=0.031）和内部HNL（分别为p<0.001和p=0.007）的严重程度更高相关，和更弥漫性内部HNL（分别为p=0.043和p=0.001）。患者报告的吞咽结局与外部HNL的严重程度更高（p=0.001）和内部HNL的弥漫性更高（p=0.002）相关。外部HNL在CRT后12个月内基本解决，但内部HNL仍然存在。外部和/或内部HNL严重程度较高的患者和内部HNL较弥散的患者可以预期有更严重的吞咽困难。
