scholarly journals A longitudinal study of the Swedish MD Anderson Dysphagia Inventory in patients with oral cancer

2020 ◽  
Vol 5 (6) ◽  
pp. 1125-1132
Author(s):  
Lisa Tuomi ◽  
Per Fransson ◽  
Johan Wennerberg ◽  
Caterina Finizia
Keyword(s):  
Longitudinal Study ◽  
Oral Cancer ◽  
Md Anderson ◽  
Anderson Dysphagia Inventory

Randomized Trial of Radiotherapy Versus Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma: Long-Term Results of the ORATOR Trial

2022 ◽  
Author(s):  
Anthony C. Nichols ◽  
Julie Theurer ◽  
Eitan Prisman ◽  
Nancy Read ◽  
Eric Berthelet ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Robotic Surgery ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Transoral Robotic Surgery ◽  
Oropharyngeal Squamous Cell Carcinoma ◽  
Md Anderson ◽  
Anderson Dysphagia Inventory ◽  
Over Time

PURPOSE The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has risen rapidly, because of an epidemic of human papillomavirus infection. The optimal management of early-stage OPSCC with surgery or radiation continues to be a clinical controversy. Long-term randomized data comparing these paradigms are lacking. METHODS We randomly assigned patients with T1-T2, N0-2 (≤ 4 cm) OPSCC to radiotherapy (RT) (with chemotherapy if N1-2) versus transoral robotic surgery plus neck dissection (TORS + ND) (with or without adjuvant therapy). The primary end point was swallowing quality of life (QOL) at 1-year using the MD Anderson Dysphagia Inventory. Secondary end points included adverse events, other QOL outcomes, overall survival, and progression-free survival. All analyses were intention-to-treat. Herein, we present long-term outcomes from the trial. RESULTS Sixty-eight patients were randomly assigned (n = 34 per arm) between August 10, 2012, and June 9, 2017. Median follow-up was 45 months. Longitudinal MD Anderson Dysphagia Inventory analyses demonstrated statistical superiority of RT arm over time ( P = .049), although the differences beyond 1 year were of smaller magnitude than at the 1-year timepoint (year 2: 86.0 ± 13.5 in the RT arm v 84.8 ± 12.5 in the TORS + ND arm, P = .74; year 3: 88.9 ± 11.3 v 83.3 ± 13.9, P = .12). These differences did not meet the threshold to qualify as a clinically meaningful change at any timepoint. Certain differences in QOL concerns including more pain and dental concerns in the TORS + ND arm seen at 1 year resolved at 2 and 3 years; however, TORS patients started to use more nutritional supplements at 3 years ( P = .015). Dry mouth scores were higher in RT patients over time ( P = .041). CONCLUSION On longitudinal analysis, the swallowing QOL difference between primary RT and TORS + ND approaches persists but decreases over time. Patients with OPSCC should be informed about the pros and cons of both treatment options (ClinicalTrials.gov identifier: NCT01590355 ).

scholarly journals Funktionelle Ergebnisse nach transmandibulärer Resektion und primärer Radiochemotherapie bei fortgeschrittenen Kopf-Hals-Plattenepithelkarzinomen

HNO ◽  
2020 ◽  
Author(s):  
A. Knopf ◽  
N. Mansour ◽  
B. Hofauer ◽  
F. Johnson ◽  
H. Bier ◽  
...  
Keyword(s):  
Visuelle Analogskala ◽  
Life Questionnaire ◽  
Funktionelle Ergebnisse ◽  
European Organization ◽  
Quality Of Life Questionnaire ◽  
Mallampati Score ◽  
Saxon Test ◽  
Md Anderson ◽  
Anderson Dysphagia Inventory

Zusammenfassung Ziel der Arbeit In dieser Studie wurden die funktionellen Ergebnisse nach transmandibulärer Resektion und Rekonstruktion mittels mikrovaskulär anastomosiertem Radialistransplantat (TMR+Tx) gegenüber einer primären Radiochemotherapie (pRCT) bei fortgeschrittenen orophayngealen Plattenepithelkarzinomen (OPSCC) verglichen. Methoden Es erfolgte ein Vergleich zwischen 50 OPSCC-Patienten mit TMR+Tx und 50 OPSCC-Patienten mit pRCT. Die Wasserschluckzeit war als primärer Endpunkt definiert. Der Saxon-Test, die maxillomandibuläre Distanz, der Mallampati-Score, der Quotient aus Körpergröße zu Gewicht, eine nasale Penetration, das Vorhandensein einer Ernährungssonde/Tracheostomie sowie 4 validierte Fragebögen (Visuelle Analogskala zur Mundtrockenheit, Sicca VAS; MD Anderson Dysphagia Inventory, MDADI; Voice Handicap Index, VHI; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Head and Neck Cancer – 35 Items, QLQ-H&N35) dienten als sonstige Endpunkte zur Beurteilung der Funktion und Lebensqualität. Ergebnisse Die Gesamtkohorte an operierten Patienten zeigte eine erhöhte Rate an nasaler Penetration (p < 0,0001), was mit einer verlängerten Wasserschluckzeit verbunden war (p < 0,05). Durch eine modifizierte Rekonstruktion des Weichgaumens wurde die nasale Penetration in der chirurgisch therapierten Gruppe im Vergleich zur klassischen Rekonstruktion signifikant reduziert (p = 0,0001). Patienten mit pRCT litten signifikant stärker an einer Xerostomie (Saxon-Test) als Patienten nach TMR+Tx und Adjuvanz (p = 0,001). In den Fragebögen zur Funktionalität und Lebensqualität zeigte sich kein Unterschied zwischen den Gruppen. Schussfolgerung Die TMR+Tx mit modifizierter Rekonstruktion und adjuvante Therapie zeigte gegenüber der pRCT vergleichbare funktionelle Ergebnisse.

scholarly journals Ποιότητα ζωής των ασθενών μετά από ολική λαρυγγεκτομή

2017 ◽  
Author(s):  
Γιάννης Θρασυβούλου
Keyword(s):  
Quality Of Life ◽  
Life Questionnaire ◽  
Cross Sectional ◽  
Quality Of Life Questionnaire ◽  
Md Anderson ◽  
Anderson Dysphagia Inventory

Η παρούσα μελέτη έχει σκοπό να συγκρίνει την οριζόντια και την κάθετη μέθοδο σύγκλισης του νεοφάρυγγα μετά από ολική λαρυγεκτομή όσον αφορά την καταποτική λειτουργία των ασθενών, και την κατάποση σε σχέση με την ποιότητα ζωής. Η πιθανή επίδραση άλλων θεραπειών και της ηλικίας εξετάστηκε επίσης. Διενεργήθηκε cross – sectional μελέτη σε 52 ασθενείς με ολική λαρυγγεκτομή. Σε όλους τους ασθενείς διανεμήθηκαν ερωτηματολόγια δυσφαγίας (MD Anderson Dysphagia Inventory) και ποιότητας ζωής (MD Anderson Quality of life Questionnaire). Για σύγκριση μεταξύ των ομάδων χρησιμοποιήθηκαν οι μη παραμετρικές δοκιμασίες Mann-Whitney και ο δείκτης κατάταξης Spearman’s. Άλλες παράμετροι όπως πρωτογενής λαρυγγεκτομή (χωρίς άλλη θεραπεία), λαρυγγεκτομή ως θεραπεία διάσωσης και λαρυγγεκτομή ακολουθούμενη από χημειοακτινοθεραπεία εξετάστηκαν με την μέθοδο Kruskal-Wallis. Χρησιμοποιήθηκαν πολλαπλή γραμμική παλινδρόμηση για να εξεταστεί η συμβολή της ομιλίας και της κατάποσης μετά την λαρυγγεκτομή, στην ποιότητα ζωής. Τα ερωτηματολόγια συμπληρώθηκαν από 34 ασθενείς; 31 άρρενες και 3 γυναίκες. Η μέση ηλικία ήταν 66.8 έτη. Οι 16 ασθενείς είχαν οριζόντια σύγκλιση του νεοφάρυγγα και οι 18 κάθετη σύγκλιση του νεοφάρυγγα. Ο δείκτης ποιότητας ζωής ήταν 91,5 (+12.5) στους ασθενείς με οριζόντια σύγκλιση και 68.3 (+18.4) στους ασθενείς με κάθετη σύγκλιση. Η τιμή του δείκτη ποιότητας ζωής ήταν 81.1 (11.67) για την οριζόντια και 80.78 (12.13) για την ομάδα της κάθετης συρραφής. Ο συντελεστής συσχέτισης ήταν θετικός και στις δύο ομάδες ασθενών, αλλά ήταν αυξημένος στην ομάδα της οριζόντιας συρραφής. Η ποιότητα ζωής και ο δείκτης δυσφαγίας δεν επηρεάστηκαν από επικουρικές θεραπείες αλλά ούτε από την ηλικία. Η οριζόντια σύγκλιση σε σύγκριση με την κάθετη σύγκλιση του νεοφάρυγγα οδηγεί σε βελτιωμένη μετεγχειρητική κατάποση – ποιότητα ζωής. Οι επικουρικές θεραπείες και η ηλικία δεν επηρεάζουν την κατάποση ή την ποιότητα ζωής. Οι ωτορινολαρυγγολόγοι πρέπει να επιλέγουν την κατάλληλη μέθοδο σύγκλισης του νεοφάρυγγα για τα βέλτιστα αποτελέσματα της κατάποσης.

O106 Quality of life in oral cancer patients – A longitudinal study

2007 ◽  
Vol 2 (1) ◽  
pp. 93
Author(s):  
V. Rao ◽  
D. Chaukar ◽  
A.D. Cruz ◽  
A. Kakade
Keyword(s):  
Quality Of Life ◽  
Longitudinal Study ◽  
Oral Cancer ◽  
Cancer Patients ◽  
Oral Cancer Patients

scholarly journals Psychometric Properties of the MDADI—A Preliminary Study of Whether Less is Truly More?

Dysphagia ◽  
2021 ◽  
Author(s):  
Daniel J. Lin ◽  
Jenan Altamimi ◽  
Kim Pearce ◽  
Janet A. Wilson ◽  
Joanne M. Patterson
Keyword(s):  
Factor Analysis ◽  
Clinical Practice ◽  
Psychometric Properties ◽  
Missing Values ◽  
Factor Model ◽  
Patient Questionnaires ◽  
Item Responses ◽  
Preliminary Study ◽  
Md Anderson ◽  
Anderson Dysphagia Inventory

AbstractThe MD Anderson Dysphagia Inventory (MDADI) is a 20-item dysphagia-specific QOL questionnaire with four subscales: global, emotional, functional, and physical. It is widely used in clinical practice and in research; however, its psychometric properties have been under-researched. We aim to evaluate the organisation of the MDADI subscales and identify any redundant items. The MDADI is a routinely collected outcome measure at two centres in northeast England. Questionnaires completed at three months following treatment were extracted from these existing databases. Factor analysis was carried out with the aim of reducing redundancy among the set of questionnaire items. Cases with missing values were excluded. A total of 196 complete patient questionnaires were used in factor analysis. A one-factor model accounted for around 50% of the total variance in item responses. The top five endorsed items (abbreviated by the questionnaire item keywords: Excluded, Irritate, Esteem, Social, and Why) in this one factor appeared in three (emotional, functional, and physical) of the four supposed MDADI subscales, i.e. global, emotional, functional, and physical. Our results suggest an overlap of three MDADI subscales across the top five endorsed items. The content of the top five questions all appear related to the psychosocial aspects of swallowing. This implies some redundancy of the items in the original subscales of the questionnaire. Using the most endorsed items, it appears feasible to abbreviate the 20-item MDADI questionnaire to a 5-item “MiniDADI” questionnaire, which is likely to have greater utility in routine clinical practice outside of research settings.

scholarly journals Clinical effectiveness of the sequential 4-channel NMES compared with that of the conventional 2-channel NMES for the treatment of dysphagia in a prospective double-blind randomized controlled study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kyoung-Ho Seo ◽  
Joonyoung Jang ◽  
Eun Gyeong Jang ◽  
Yulhyun Park ◽  
So Young Lee ◽  
...  
Keyword(s):  
Neuromuscular Electrical Stimulation ◽  
Oral Intake ◽  
Clinical Effectiveness ◽  
Controlled Study ◽  
Double Blind ◽  
Registration Number ◽  
Md Anderson ◽  
Functional Oral Intake Scale ◽  
Anderson Dysphagia Inventory

Abstract Background To date, conventional swallowing therapies and 2-channel neuromuscular electrical stimulation (NMES) are standard treatments for dysphagia. The precise mechanism of 2-channel NMES treatment has not been determined, and there are controversies regarding the efficacy of this therapy. The sequential 4-channel NMES was recently developed and its action is based on the normal contractile sequence of swallowing-related muscles. Objective To evaluate and compare the rehabilitative effectiveness of the sequential 4-channel NMES with that of conventional 2-channel NMES. Methods In this prospective randomized case–control study, 26 subjects with dysphagia were enrolled. All participants received 2- or 4-channel NMES for 2–3 weeks (minimal session: 7 times, treatment duration: 300–800 min). Twelve subjects in the 4-channel NMES group and eleven subjects in the 2-channel NMES group completed the intervention. Initial and follow-up evaluations were performed using the videofluoroscopic dysphagia scale (VDS), the penetration-aspiration scale (PAS), the MD Anderson dysphagia inventory (MDADI), the functional oral intake scale (FOIS), and the Likert scale. Results The sequential 4-channel NMES group experienced significant improvement in their VDS (oral, pharyngeal, and total), PAS, FOIS, and MDADI (emotional, functional, and physical subsets) scores, based on their pretreatment data. VDS (oral, pharyngeal, and total) and MDADI (emotional and physical subsets) scores, but not PAS and FOIS scores, significantly improved in the 2-channel NMES group posttreatment. When the two groups were directly compared, the 4-channel NMES group showed significant improvement in oral and total VDS scores. Conclusions The sequential 4-channel NMES, through its activation of the suprahyoid and thyrohyoid muscles, and other infrahyoid muscles mimicking physiological activation, may be a new effective treatment for dysphagia. Trial registration: clinicaltrial.gov, registration number: NCT03670498, registered 13 September 2018, https://clinicaltrials.gov/ct2/show/NCT03670498?term=NCT03670498&draw=2&rank=1.

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