Radyoterapi uygulanan baş boyun kanserli hastalarda yutma fonksiyonunun klinik ve dozimetrik parametrelerle değerlendirilmesi
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Tarih
2016
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Baş boyun kanserlerinin küratif tedavisinde radyoterapi ve kemoterapi kombinasyonlarıyla başarılı sonuçlar elde edilmiştir. Eş zamanlı radyokemoterapi uygulamasında, disfaji sık gözlenen bir yan etkidir ve hastaların hayat kalitesini bozmaktadır. Bu çalışmada, küratif radyoterapi ± kemoterapi uygulanan 26 baş boyun kanseri hastası disfaji açısından klinik ve dozimetrik parametrelerle değerlendirildi. Her hasta için hedef hacimler, risk altındaki organlar ve yutma ile ilişkili organlar simülasyon bilgisayarlı tomografi kesitlerinde uygun şekilde konturlandı ve tedavi planlarından dozimetrik veriler elde edildi. Hastalar anket modülü (EORTC QLQ-H&N35) ve aspirasyon skorlaması (Leipzig skorlaması) ile subjektif olarak; video larengoskopi altında muayene bulguları (glottik kapanma anomalisi, farengeal sekresyon) ile objektif olarak değerlendirildi. Klinik bulgularla dozimetrik veriler arasındaki ilişkiler incelendi. Sonuç olarak radyokemoterapi ilişkili disfajinin, yutma fonksiyonundan sorumlu hemen tüm anatomik yapıların doz-volüm parametreleri ile ilişkili olduğu gözlendi.
abstract
With the use of combined chemotherapy and radiotherapy, successful results has been achieved for curative treatment of head and neck cancers. Dysphagia is a common complication of concurrent radiochemotherapy approach in head and neck cancer patients and it may worsen quality of life for patients. In this study, 26 head and neck cancer patients treated with curative radiotherapy ± chemotherapy, has been evaluated for dysphagia by analysing the correlation between clinical and dosimetric parameters. Target volumes, organs at risk and swallowing related organs were properly contoured on simulation computed tomography images for each patient and dosimetric data were obtained from radiation treatment plans. Patients were subjectively evaluated with EORTC QLQ-H&N35 questionnaire and Leipzig aspiration scale; and objectively evaluated on examination with video laryngoscopy for the presence of glottal closure abnormality and the presence of pharyngeal secretion. Correlations between dosimetric data and clinical findings were analyzed. Consequently, radiochemotherapy related dysphagia was found associated with almost all dose volume parameters of anatomic structures responsible for swallowing function.
abstract
With the use of combined chemotherapy and radiotherapy, successful results has been achieved for curative treatment of head and neck cancers. Dysphagia is a common complication of concurrent radiochemotherapy approach in head and neck cancer patients and it may worsen quality of life for patients. In this study, 26 head and neck cancer patients treated with curative radiotherapy ± chemotherapy, has been evaluated for dysphagia by analysing the correlation between clinical and dosimetric parameters. Target volumes, organs at risk and swallowing related organs were properly contoured on simulation computed tomography images for each patient and dosimetric data were obtained from radiation treatment plans. Patients were subjectively evaluated with EORTC QLQ-H&N35 questionnaire and Leipzig aspiration scale; and objectively evaluated on examination with video laryngoscopy for the presence of glottal closure abnormality and the presence of pharyngeal secretion. Correlations between dosimetric data and clinical findings were analyzed. Consequently, radiochemotherapy related dysphagia was found associated with almost all dose volume parameters of anatomic structures responsible for swallowing function.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Radyoterapi, Baş Boyun Kanserleri, Disfaji, Radiotherapy, Head and Neck Cancers, Dysphagia
