The evaluation of the intensity of radiation reaction using Dische scale in prediction of swallowing dysfunction and quality of life deterioration in patients with head and neck cancer treated with combined therapy including surgery, chemotherapy and radi
Abstract
Introduction. Head and neck cancers are typified by the localization affecting the quality of life of patients by directly including the organs responsible for the swallowing which are in the area of surgery and radiation therapy. Because of poor prognosis in these tumors an aggressive combined therapy is applied including surgery, chemotherapy and radiotherapy. Such a treatment is charged with higher toxicity, affecting the quality of life. The aim of the study was the analysis of clinical impact of the evaluation of the intensity of the radiation reaction with Dische scale in patients with head and neck cancers and its relation with the incidence of dysphagia in patients following the oncological combined treatment and its influence on the quality of life of the patients.
Material and methods. The group of 135 patients with head and neck cancers treated in a combined mode (surgery, chemotherapy, radiotherapy) in Oncological Center between 2008-2014. The intensity of radiation reaction was monitored with Dische scale during and after the treatment. The quality of life and subjective evaluation of swallowing function was assessed using MDADI (M.D. Anderson Dysphagia Inventory).
Results. Statistically significantly worse subjective quality of life with dysphagia was seen in patients with the highest intensity of radiation reaction measured with Dische scale when compared to patients with medium and minimal reactions (p = 0.01).
Conclusions. During the combined oncological treatment an acute radiation reaction develops, which has to be precisely monitored and intensively treated to enable to realization of the treating plan. The evaluation of the intensity of radiation reaction using Dische scale is a very useful and clinically needful tool for the proper evaluation of clinical stage of the patients during the oncological treatment. The intensity of radiation reaction is related with the early and late dysphagia and affects the quality of life of the patients following the oncological treatment. The high rate of Dische intensity scale might predict dysphagia.
Keywords: dysphagiaradiation reactionDische scalequality of life
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