A Longitudinal Follow-Up of Pre- and Post-Surgery Swallowing Function Related Quality of Life and Swallowing-Respiration Coordination in Oral Cavity Cancer

Project: National Science and Technology CouncilNational Science and Technology Council Academic Grants

Project Details

Abstract

Background: Most head and neck cancers are located at oral cavity, and oral cavity cancer is an important health issue in Taiwan. Moreover, squamous cell carcinoma (SCC) is the most common cancer (90%) of oral cavity cancer. Radical surgery of tumor is the major treatment, and adjunctive therapies with radiotherapy or chemoradiotherapy may be necessary. There are studies demonstrated of dysphagia (swallowing disorders) in oral cavity SCC (OC-SCC) at before and after surgery, and follow-ups after surgery. Moreover, the symptoms of dysphagia may be aggravated by adjunctive radiotherapy or chemoradiotherapy. The assessment of swallowing outcomes includes bedside tests, swallowing related quality of life (QoL) questionnaires, and instrumental studies. However, the swallowing and respiration coordination (SRC) is important for safety swallowing without aspiration. There were studies that demonstrated the SRC and Heart rate variability (HRV) affected in head and neck cancer. Besides, the visual feedback training program to optimize SRC in head and neck cancer was suggested. Moreover, in OC-SCC, there was neither longitudinal nor long-term follow-up study of SRC, and swallowing function related QoL found.Aims: To investigate the HRV, SRC, and swallowing function and related QoL in OC-SCC at pre-surgery, post-surgery, and follow-ups after. Materials and Methods: A three year plan study, 120 patients of OC-SCC will be recruited and followed-up consecutively, and 30 no dysphagic normal subjects will be recruited. Patients will receive 5 assessments at different follow-up periods that will be one baseline at pre-surgery, and four follow-ups at 3 months, 6 months, 9 months, and 12 months post-surgery. The assessments will include questionnaires of swallowing function and related QoL, HRV, and non-invasive SRC studies. Normal controls will have one non-invasive SRC assessment, and HRV study.Outcome measurements to compare: 1. Clinical characteristics: pre-surgery: age, body weight, site and volume of caner image (MRI or CT or PET), stage of TMN; type of surgery; radiotherapy or chemoradiotherapy after surgery. 2. Questionnaires of swallowing function and related QoL: FOIS, EAT-10, MDADI, EORTC QLQ-C30, PDQ-39.3. Non-invasive SRC study: parameters of oropharyngeal phases, swallowing respiratory pause, pre- and post-swallowing respiratory phase pattern, and piece-meal deglutition.4. HRV. Anticipatory results:1. OC-SCC group will demonstrate sub-optimal SRC pre-surgery compare to normal control.2. OC-SCC group will demonstrate worse SRC, swallowing function and its related QoL at 3 months post-surgery compare to the baseline pre-surgery. The worst SRC, and swallowing function and its related QoL at 3 months post-surgery in OC-SCC will be shown, and the improvement at 6 months post-surgery will be demonstrated, then the improvement will reach the plateau at 9 months post-surgery.3. The correlation between non-invasive SRC study and swallowing function and its related QoL which at different follow-up periods will be analyzed within OC-SCC group.4. HRV in OC-SCC will demonstrate worse post-surgery, and improve to plateau at 9 months post-surgery.

Project IDs

Project ID:PC10707-0102
External Project ID:MOST107-2314-B182-010
StatusFinished
Effective start/end date01/08/1831/07/19

Keywords

  • oral cavity cancer
  • squamous cell carcinoma
  • questionnaire
  • non-invasive
  • sensor
  • sEMG
  • thyroid excursion
  • swallowing and respiration coordination

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