Laryngorhinootologie 2007; 86(12): 846-852
DOI: 10.1055/s-2007-967028
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Schluckrehabilitation nach moderner Tumortherapie im Kopf-Hals-Bereich

Posttreatment Rehabilitation of Swallowing in Patients with Head and Neck CancerR.  O.  Seidl1 , R.  Nusser-Müller-Busch2
  • 1Klinik für Hals-, Nasen-, Ohrenheilkunde, (Direktor: Prof. Dr. med. A. Ernst)
  • 2Abteilung für physikalische Therapie und Rehabilitation, Logopädie
Further Information

Publication History

Publication Date:
31 October 2007 (online)

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.

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

    >