Long‐term neck and shoulder function among survivors of oropharyngeal squamous cell carcinoma treated with chemoradiation as assessed with the neck dissection impairment index
| Autor: | Alexander T. Pearson, Sarah J. Burgin, Carol R. Bradford, Douglas B. Chepeha, Jeffrey M. Vainshtein, Emily Bellile, Mark E. Prince, Francis P. Worden, Gregory T. Wolf, Matthew E. Spector, Andrew J. Rosko, Avraham Eisbruch, Scott A. McLean |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Shoulder medicine.medical_specialty medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Quality of life medicine Shoulder function Humans Survivors Neck stiffness Neck pain Squamous Cell Carcinoma of Head and Neck business.industry Neck dissection Chemoradiotherapy Middle Aged Surgery Cross-Sectional Studies Otorhinolaryngology Head and Neck Neoplasms 030220 oncology & carcinogenesis Neck Dissection Female medicine.symptom business Body mass index 030217 neurology & neurosurgery Neck Dissection Impairment Index |
| Zdroj: | Head & Neck. 43:1621-1628 |
| ISSN: | 1097-0347 1043-3074 |
| DOI: | 10.1002/hed.26636 |
| Popis: | Background Of interest is the long-term neck and shoulder impairment of patients treated with primary chemoradiotherapy (CRT). This is important for counseling patients regarding treatment decisions when discussing primary CRT. Methods A cross-sectional study to identify factors that contribute to neck and shoulder dysfunction in patients treated with primary CRT. We utilized the neck dissection impairment index (NDII). Eighty-seven patients treated between 2003 and 2010, who were free of disease, responded; 24 of these 87 underwent post-CRT neck dissection. Mean interval since completion of CRT was over 5 years (62.7 months). Mean age, 63.5 years, male:female 75:12. Results Mean NDII score was 87.4 (SD 22.1, range 5-100). Multiple linear regression revealed worse NDII scores for patients with larger pre-CRT gross tumor nodal volume (GTVnodal), controlled for age, sex, body mass index (BMI), and the presence of neck dissection (p = 0.02). There were significant associations with increasing GTVnodal and "low" scores for components of the NDII that assessed neck pain (p = 0.02), neck stiffness (p = 0.01), lifting heavy objects (p = 0.02), reaching overhead (p = 0.02), and ability to do work (p = 0.02). Physical therapy (PT) was evaluated as an "anchor" but it was prescribed "as needed." Regression revealed participation in PT was associated with higher GTVnodal, lower BMI, presence of neck dissection, and female sex (p = 0.00007). Conclusion GTVnodal was an independent predictor of neck and shoulder impairment. High GTVnodal was associated with increased pain and stiffness, and increased difficulty lifting heavy objects, reaching overhead, overall ability to perform work-related tasks and was associated with participation in post-treatment PT. |
| Databáze: | OpenAIRE |
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