AN EVALUATION OF SWALLOWING FUNCTION AFTER CANCER TREATMENT IN HEAD AND NECK CANCER PATIENTS

Abstract

Purpose: Evaluation of swallowing and feeding types are essential in patients with head and neck cancer (HNC). This study aimed to evaluate the swallowing function of patients treated for HNC. Methods: One hundred fifty-seven patients with HNC who were referred for swallowing disorder were included. Descriptive information including age, gender, weight, height, diagnosis, and feeding type was recorded. Videofluoroscopic swallowing study (VFSS) was performed to assess swallowing function. Penetration and aspiration severity was determined using the Penetration and Aspiration Scale (PAS). Results: The mean age was 54.16±12.90 years, of which 66.9% was male. The 23.6% of patients were treated for oropharyngeal cancer, 17.2% for nasopharyngeal cancer, and 59.2% for hypopharyngeal cancer. The 26.75% of patients underwent surgery, and 25.5% received chemoradiotherapy, and 45.9% underwent surgery combined with chemoradiotherapy. The mean PAS score for liquid was 4.96±2.93, and the mean PAS score for pudding was 3.76±3.05 according to the VFSS. While only liquid aspiration was 70.1%, aspiration in liquid and pudding was 37.2%. A significant difference was found between referral and recommended feeding types (p=0.003). No difference was detected in terms of PAS score for liquids, PAS score for pudding, and recommended feeding type according to received treatment types (p>0.05). Conclusion: More than half of the patients had airway aspiration, and their referral feeding type was not appropriate. Therefore, swallowing function should be evaluated in patients with HNC, and appropriate feeding type should be determined in an early period.

Keywords

• Chemotherapy
• Dysphagia
• Head and Neck Cancer

BAŞ VE BOYUN KANSERLİ HASTALARDA KANSER TEDAVİSİ SONRASI YUTMA FONKSİYONUNUN DEĞERLENDİRİLMESİ

Öz

Amaç: Baş ve boyun kanserlerinde yutmanın ve beslenme şeklinin belirlenmesi önemlidir. Bu çalışmanın amacı, baş ve boyun kanseri (BBK) tedavisi almış hastaların yutma fonksiyonlarının değerlendirilmesi idi. Yöntem: Çalışmaya yutma bozukluğu şikâyeti ile başvuran 157 BBK'lı hasta dahil edildi. Hastaların yaş, cinsiyet, boy, vücut ağırlığı, tanı ve beslenme şekli gibi tanımlayıcı bilgileri kaydedildi. Yutma fonksiyonunun değerlendirilmesi için videofloroskopik yutma çalışması (VFYÇ) yapıldı. Penetrasyon ve aspirasyon şiddetini belirlemede Penetrasyon ve Aspirasyon Skalası (PAS) kullanıldı. Sonuçlar: Yaş ortalaması 54,16±12,90 yıl olan hastaların % 66,9'u erkekti. Hastaların % 23,6'sı orofarengeal kanser, % 17,2'si nazofarengeal kanser ve % 59,2'si hipofarengeal bölge kanseri için tedavi edilmişti. Hastaların % 26,7'si cerrahi tedavi, % 25,5'i kemoradyoterapi ve % 45,9'u cerrahi ve kemoradyoterapi tedavisini birlikte almıştı. Hastaların VFYÇ'ye göre ortalama PAS sıvı skoru 4,96±2,93 ve kıvamlı skoru 3,76±3,05 idi. Sadece sıvı aspirasyonu % 70,1 iken, kıvamlı gıdalarda aspirasyon % 37,2 idi. Başvuru beslenme şekli ile önerilen beslenme şekli arasında istatistiksel olarak anlamlı fark bulundu (p=0,003). Uygulanan tedavi tipine göre sıvı PAS skoru, kıvamlı PAS skoru ve önerilen beslenme şekli açısından anlamlı fark bulunamadı (p>0,05). Tartışma: BBK'lı hastaların yarısından fazlasında havayolu aspirasyonu olduğu ve mevcut beslenme şekillerinin uygun olmadığı tespit edildi. Bu nedenle, BBK'lı hastalarda yutma fonksiyonu değerlendirilmeli ve erken dönemde doğru beslenme şekli belirlenmelidir.

Anahtar Kelimeler

• Kemoterapi
• Disfaji
• Baş ve Boyun Kanserleri

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