目的:确定预测口咽癌患者放疗后吞咽困难的吞咽相关结构(SRS)。
方法:在2020年9月至2022年10月之间,选择在至少一年前完成放疗且无复发或残留的口鼻咽癌患者。他们接受了吞咽(FEES)评估和吞咽困难分级的灵活内窥镜评估。重新计算传递到其SRS的平均辐射剂量。分析了辐射剂量与每个SRS和FEES评分之间的相关性。
结果:29名参与者,51-73岁,已注册。6例患者接受了二维放疗,八人接受了三维适形放射治疗,15人接受了调强放射治疗。下咽部收缩器的辐射剂量,半固体饮食(p=0.023、0.030和0.001)和流质饮食(p=0.021、0.013和0.002)均显着预测吞咽困难。食道入口显着预测仅液体饮食的吞咽结果(p=0.007)。
结论:本研究支持在口咽放疗期间保留SRS可改善吞咽结局。
OBJECTIVE: To identify swallowing-related structures (SRSs) predicting post-radiotherapy dysphagia in oropharyngeal carcinoma patients.
METHODS: Between September 2020 and October 2022, oropharyngeal cancer patients who had completed radiotherapy at least one year before without recurrence or residuals were selected. They underwent flexible endoscopic evaluation of swallowing (FEES) assessments and dysphagia grading. The mean radiation doses delivered to their SRSs were recalculated. The correlation between radiation doses to each SRS and FEES scores was analysed.
RESULTS: Twenty-nine participants, aged 51-73 years, were enrolled. Six patients had received two-dimensional radiotherapy, eight had undergone three-dimensional conformal radiotherapy, and fifteen had received intensity-modulated radiation therapy. Radiation doses to the inferior pharyngeal constrictor, cricopharyngeus and glottic larynx significantly predicted dysphagia for both semisolids (p = 0.023, 0.030 and 0.001) and liquid diets (p = 0.021, 0.013 and 0.002). The esophageal inlet significantly predicted swallowing outcomes for only the liquid diet (p = 0.007).
CONCLUSIONS: This study supports that SRS-sparing during radiotherapy for oropharyngeal cancers improves swallowing outcomes.