Zusammenfassung
Schluckstörungen nach einer Therapie von Tumorerkrankungen im Kopf-Hals-Bereich sind
Komplikationen, die für die Patienten schwerwiegende Folgen haben können. Eine frühzeitige
interdisziplinäre Diagnostik und die Einleitung geeigneter therapeutischer Maßnahmen
sind notwendig, um die Anzahl und die Folgen dieser Komplikationen zu minimieren.
In einer Übersicht werden die Voraussetzungen, Möglichkeiten und Grenzen der Rehabilitation
von Schluckstörungen unter einer modernen Tumortherapie im Kopf-Hals-Bereich diskutiert.
Abstract
Dysphagias after a tumor therapy in the head neck area are complications which can
have serious consequences for the patients. An early interdisciplinary diagnostics
and the induction of appropriate therapeutic measures are necessary to minimize the
number and the results of these complications. In this review the conditions, possibilities
and limits of the rehabilitation of dysphagia are discussed.
Schlüsselwörter
Dysphagie - Kopf- und Hals-Tumoren - Therapie - Ernährung - Mukositis - Xerostomie
Key words
dysphagia - nutrition - head and neck neoplasm - mucositis - xerostomia
Literatur
- 1
Abitbol A A, Sridhar K S, Lewin A A, Schwade J G, Raub W J, Wolfson A, Gonzalez-Angulo C,
Adessa A, Goodwin W J, Markoe A M.
Hyperfractionated radiation therapy and 5-fluorouracil, cisplatin, and mitomycin-C
(+/-granulocyte-colony stimulating factor) in the treatment of patients with locally
advanced head and neck carcinoma.
Cancer.
1997;
80
266-276
- 2
Adelstein D J, Li Y, Adams G L, Wagner H J, Kish J A, Ensley J F, Schuller D E, Forastiere A A.
An intergroup phase III comparison of standard radiation therapy and two schedules
of concurrent chemoradiotherapy in patients with unresectable squamous cell head and
neck cancer.
J Clin Oncol.
2003;
21
92-98
- 3
Al-Othman M OF, Amdur R J, Morris C G, Hinerman R W, Mendenhall W M.
Does feeding tube placement predict for long-term swallowing disability after radiotherapy
for head and neck cancer?.
Head Neck.
2003;
25
741-747
- 4
Ang K K, Harris J, Garden A S, Trotti A, Jones C U, Carrascosa L, Cheng J D, Spencer S S,
Forastiere A, Weber R S.
Concomitant boost radiation plus concurrent cisplatin for advanced head and neck carcinomas:
radiation therapy oncology group phase II trial 99 - 14.
J Clin Oncol.
2005;
23
3008-3015
- 5 Bartolome G, Schröter-Morasch H (Hrsg). Schluckstörungen: Diagnostik und Rehabilitation. Jena;
Elsevier, Urban und Fischer 2006 XII: 468
- 6
Bernal-Sprekelsen M, Vilaseca-Gonzalez I, Blanch-Alejandro J.
Predictive values for aspiration after endoscopic laser resections of malignant tumors
of the hypopharynx and larynx.
Head Neck.
2004;
26
103-110
- 7
Bonner J A, Harari P M, Giralt J, Azarnia N, Shin D M, Cohen R B, Jones C U, Sur R,
Raben D, Jassem J, Ove R, Kies M S, Baselga J, Youssoufian H, Amellal N, Rowinsky E K,
Ang K K.
Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck.
N Engl J Med.
2006;
354
567-578
- 8
Brizel D M, Wasserman T H, Henke M, Strnad V, Rudat V, Monnier A, Eschwege F, Zhang J,
Russell L, Oster W, Sauer R.
Phase III randomized trial of amifostine as a radioprotector in head and neck cancer.
J Clin Oncol.
2000;
18
3339-3345
- 9
Buntzel J, Glatzel M, Mucke R, Micke O, Bruns F.
Influence of amifostine on late radiation-toxicity in head and neck cancer - a follow-up
study.
Anticancer Res.
2007;
27
1953-1956
- 10
Burns J L, Mancoll J S, Phillips L G.
Impairments to wound healing.
Clin Plast Surg.
2003;
30
47-56
- 11
Denittis A S, Machtay M, Rosenthal D I, Sanfilippo N J, Lee J H, Goldfeder S, Chalian A A,
Weinstein G S, Weber R S.
Advanced oropharyngeal carcinoma treated with surgery and radiotherapy: oncologic
outcome and functional assessment.
Am J Otolaryngol.
2001;
22
329-335
- 12
Dorr W, Hendry J H.
Consequential late effects in normal tissues.
Radiother Oncol.
2001;
61
223-231
- 13
Eisbruch A, Kim H M, Terrell J E, Marsh L H, Dawson L A, Ship J A.
Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck
cancer.
Int J Radiat Oncol Biol Phys.
2001;
50
695-704
- 14
Eisbruch A, Shewach D S, Bradford C R, Littles J F, Teknos T N, Chepeha D B, Marentette L J,
Terrell J E, Hogikyan N D, Dawson L A, Urba S, Wolf G T, Lawrence T S.
Radiation concurrent with gemcitabine for locally advanced head and neck cancer: a
phase I trial and intracellular drug incorporation study.
J Clin Oncol.
2001;
19
792-799
- 15
Eisele D W, Koch D G, Tarazi A E, Jones B.
Case report: aspiration from delayed radiation fibrosis of the neck.
Dysphagia.
1991;
6
120-122
- 16
Epstein J B, Gorsky M, Guglietta A, Le N, Sonis S T.
The correlation between epidermal growth factor levels in saliva and the severity
of oral mucositis during oropharyngeal radiation therapy.
Cancer.
2000;
89
2258-2265
- 17
Franzmann E J, Lundy D S, Abitbol A A, Goodwin W J.
Complete hypopharyngeal obstruction by mucosal adhesions: a complication of intensive
chemoradiation for advanced head and neck cancer.
Head Neck.
2006;
28
663-670
- 18
Fujimoto Y, Hasegawa Y, Yamada H, Ando A, Nakashima T.
Swallowing function following extensive resection of oral or oropharyngeal cancer
with laryngeal suspension and cricopharyngeal myotomy.
Laryngoscope.
2007;
117
1343-1348
- 19
Gillespie M B, Brodsky M B, Day T A, Lee F, Martin-Harris B.
Swallowing-related quality of life after head and neck cancer treatment.
Laryngoscope.
2004;
114
1362-1367
- 20 Jones B, Donner M W. Normal and abnormal swallowing. New York; Springer 2002
- 21
Jones H A, Hershock D, Machtay M, Chalian A A, Weber R S, Weinstein G S, Schumacher K,
Kligerman M M, Berlin J A, Rosenthal D I.
Preliminary investigation of symptom distress in the head and neck patient population:
validation of a measurement instrument.
Am J Clin Oncol.
2006;
29
158-162
- 22
Khariwala S S, Vivek P P, Lorenz R R, Esclamado R M, Wood B, Strome M, Alam D S.
Swallowing outcomes after microvascular head and neck reconstruction: a prospective
review of 191 cases.
Laryngoscope.
2007;
117
1359-1363
- 23
Kulbersh B D, Rosenthal E L, McGrew B M, Duncan R D, McColloch N L, Carroll W R, Magnuson J S.
Pretreatment, preoperative swallowing exercises may improve dysphagia quality of life.
Laryngoscope.
2006;
116
883-886
- 24 Langmore S E. Endoscopic evaluation and treatment of swallowing disorders. New
York, Stuttgart; Thieme 2001
- 25
Lazarus C L, Logemann J A, Pauloski B R, Colangelo L A, Kahrilas P J, Mittal B B,
Pierce M.
Swallowing disorders in head and neck cancer patients treated with radiotherapy and
adjuvant chemotherapy.
Laryngoscope.
1996;
106
1157-1166
- 26
Lee J H, Machtay M, Unger L D, Weinstein G S, Weber R S, Chalian A A, Rosenthal D I.
Prophylactic gastrostomy tubes in patients undergoing intensive irradiation for cancer
of the head and neck.
Arch Otolaryngol Head Neck Surg.
1998;
124
871-875
- 27
Lees J.
Nasogastric and percutaneous endoscopic gastrostomy feeding in head and neck cancer
patients receiving radiotherapy treatment at a regional oncology unit: a two year
study.
Eur J Cancer Care (Engl).
1997;
6
45-49
- 28
Lin A, Jabbari S, Worden F P, Bradford C R, Chepeha D B, Teknos T N, Liao J J, Nyquist G G,
Tsien C, Schipper M J, Urba S, Wolf G T, Eisbruch A.
Metabolic abnormalities associated with weight loss during chemoirradiation of head-and-neck
cancer.
Int J Radiat Oncol Biol Phys.
2005;
63
1413-1418
- 29
List M A, D’Antonio L L, Cella D F, Siston A, Mumby P, Haraf D, Vokes E.
The Performance Status Scale for Head and Neck Cancer Patients and the Functional
Assessment of Cancer Therapy-Head and Neck Scale. A study of utility and validity.
Cancer.
1996;
77
2294-2301
- 30 Logemann J. Evaluation and treatment of swallowing disorders. Austin, Texas; Pro-ed
1998
- 31
Lvoff G, O’Brien C J, Cope C, Lee K K.
Sensory recovery in noninnervated radial forearm free flaps in oral and oropharyngeal
reconstruction.
Arch Otolaryngol Head Neck Surg.
1998;
124
1206-1208
- 32
Mekhail T M, Adelstein D J, Rybicki L A, Larto M A, Saxton J P, Lavertu P.
Enteral nutrition during the treatment of head and neck carcinoma: is a percutaneous
endoscopic gastrostomy tube preferable to a nasogastric tube?.
Cancer.
2001;
91
1785-1790
- 33
Metheny N A, Eisenberg P, Spies M.
Aspiration pneumonia in patients fed through nasoenteral tubes.
Heart and Lung.
1986;
15
256-261
- 34 Motzko M, Mlynczak U, Prinzen C. Stimm- und Schlucktherapie nach Larynx- und Hypopharynxkarzinomen. München;
Elsevier, Urban und Fischer 2004
- 35
Murphy B, Smith K, Dowling E.
Baseline swallowing function for patients treated on E2399: A phase II trial of function
perservation with induction paclitaxel/carboplatin followes by radiation plus weekly
paclitaxel.
Proc Am Soc Clin Oncol.
2003;
22
498
- 36
Nguyen N P, Frank C, Moltz C C, Vos P, Smith H J, Bhamidipati P V, Karlsson U, Nguyen P D,
Alfieri A, Nguyen L M, Lemanski C, Chan W, Rose S, Sallah S.
Aspiration rate following chemoradiation for head and neck cancer: an underreported
occurrence.
Radiother Oncol.
2006;
80
302-306
- 37
Nguyen N P, Moltz C C, Frank C, Vos P, Smith H J, Nguyen P D, Nguyen L M, Dutta S,
Lemanski C, Sallah S.
Impact of swallowing therapy on aspiration rate following treatment for locally advanced
head and neck cancer.
Oral Oncol.
2007;
43
352-357
- 38
Nguyen N P, Sallah S, Karlsson U, Antoine J E.
Combined chemotherapy and radiation therapy for head and neck malignancies: quality
of life issues.
Cancer.
2002;
94
1131-1141
- 39 Nusser-Müller-Busch R (Hrsg). Die Therapie des Facio-Oralen Trakts. Berlin; Springer
2007
- 40
Pauloski B R, Logemann J A.
Impact of tongue base and posterior pharyngeal wall biomechanics on pharyngeal clearance
in irradiated postsurgical oral and oropharyngeal cancer patients.
Head Neck.
2000;
22
120-1231
- 41
Rabinovitch R, Grant B, Berkey B A, Raben D, Ang K K, Fu K K, Cooper J S.
Impact of nutrition support on treatment outcome in patients with locally advanced
head and neck squamous cell cancer treated with definitive radiotherapy: a secondary
analysis of RTOG trial 90 - 03.
Head Neck.
2006;
28
287-296
- 42
Robbins K T.
Barriers to winning the battle with head-and-neck cancer.
Int J Radiat Oncol Biol Phys.
2002;
53
4-5
- 43
Rosenthal D I, Lewin J S, Eisbruch A.
Prevention and treatment of dysphagia and aspiration after chemoradiation for head
and neck cancer.
J Clin Oncol.
2006;
24
2636-2643
- 44
Seidl R O, Todt I, Zamani F, Ernst A.
Modified set back tongue flap: an alternative surgical approach in the reconstruction
of defects of the base of the tongue.
HNO.
2003;
51
558-562
- 45
Seven H, Calis A B, Turgut S.
A randomized controlled trial of early oral feeding in laryngectomized patients.
Laryngoscope.
2003;
113
1076-1079
- 46
Staar S, Rudat V, Stuetzer H, Dietz A, Volling P, Schroeder M, Flentje M, Eckel H E,
Mueller R P.
Intensified hyperfractionated accelerated radiotherapy limits the additional benefit
of simultaneous chemotherapy-results of a multicentric randomized German trial in
advanced head-and-neck cancer.
Int J Radiat Oncol Biol Phys.
2001;
50
1161-1171
- 47
Terrell J E, Ronis D L, Fowler K E, Bradford C R, Chepeha D B, Prince M E, Teknos T N,
Wolf G T, Duffy S A.
Clinical predictors of quality of life in patients with head and neck cancer.
Arch Otolaryngol Head Neck Surg.
2004;
130
401-408
- 48
Trotti A, Bellm L A, Epstein J B, Frame D, Fuchs H J, Gwede C K, Komaroff E, Nalysnyk L,
Zilberberg M D.
Mucositis incidence, severity and associated outcomes in patients with head and neck
cancer receiving radiotherapy with or without chemotherapy: a systematic literature
review.
Radiother Oncol.
2003;
66
253-262
- 49
Varnier A, Iona L, Dominutti M C, Deotto E, Bianchi L, Iengo A, Zacquini S, di Benedetto P.
Percutaneous endoscopic gastrostomy: complications in the short and long-term follow-up
and efficacy on nutritional status.
Eura Medicophys.
2006;
42
23-26
- 50
Waters T M, Logemann J A, Pauloski B R, Rademaker A W, Lazarus C L, Newman L A, Hamner A K.
Beyond efficacy and effectiveness: conducting economic analyses during clinical trials.
Dysphagia.
2004;
19
109-119
- 51
Winklmaier U, Wust K, Plinkert P K, Wallner F.
The accuracy of the modified Evans blue dye test in detecting aspiration in head and
neck cancer patients.
Eur Arch Otorhinolaryngol.
2007;
264
1059-1064
- 52
Wu C H, Hsiao T Y, Ko J Y, Hsu M M.
Dysphagia after radiotherapy: endoscopic examination of swallowing in patients with
nasopharyngeal carcinoma.
Ann Otol Rhinol Laryngol.
2000;
109
320-325
Dr. med. R. O. Seidl
Stellv. Klinikdirektor der Klinik für Hals-, Nasen-, Ohrenheilkunde
Unfallkrankenhaus Berlin
Warener Straße 7
12683 Berlin
eMail: roseidl@ukb.de
