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A prospective evaluation of neck and shoulder function following treatments of early-stage human papillomavirus-associated oropharynx cancer.
Gulati, Arushi; Plonowska-Hirschfeld, Karolina; Stephens, Erika M; Kansara, Sagar; Zebolsky, Aaron L; Ochoa, Edgar; Xu, Mary J; Ha, Patrick K; Heaton, Chase M; Yom, Sue S; Chan, Jason W; Algazi, Alain P; Kang, Hyunseok; Ryan, William R.
Afiliação
  • Gulati A; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
  • Plonowska-Hirschfeld K; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
  • Stephens EM; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
  • Kansara S; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
  • Zebolsky AL; Department of Otolaryngology-Head and Neck Surgery, University of Tennessee-Memphis, Memphis, Tennessee, USA.
  • Ochoa E; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
  • Xu MJ; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
  • Ha PK; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
  • Heaton CM; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
  • Yom SS; Department of Radiation Oncology, University of California, San Francisco, California, USA.
  • Chan JW; Department of Radiation Oncology, University of California, San Francisco, California, USA.
  • Algazi AP; Division of Hematology and Oncology, University of California, San Francisco, California, USA.
  • Kang H; Division of Hematology and Oncology, University of California, San Francisco, California, USA.
  • Ryan WR; Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA.
Clin Otolaryngol ; 48(5): 756-765, 2023 Sep.
Article em En | MEDLINE | ID: mdl-37212448
ABSTRACT

OBJECTIVES:

To compare post-treatment neck and shoulder function between human papillomavirus-associated oropharynx squamous cell carcinoma (HPV + OPSCC) treatments.

DESIGN:

Prospective, repeated-measures study.

SETTING:

Tertiary care center.

PARTICIPANTS:

Treatment-naïve patients with American Joint Committee on Cancer eighth edition stage T0-3/N0-2 HPV+OPSCC. MAIN OUTCOME

MEASURES:

Patients completed the Neck Dissection Impairment Index (NDII) pre-treatment and 3-months and 1-year post-treatment. The NDII assesses 10 neck and shoulder functions scored 0-5 (total score 0-100), with higher scores suggesting better function.

RESULTS:

A total of 106 patients underwent surgery alone (SA, n = 46, 43%), surgery with adjuvant radiation ± chemotherapy (S + a[C]XRT, n = 18, 17%), or definitive radiation ± chemotherapy (d[C]XRT, n = 42, 40%). cTN classification and pre-treatment NDII scores did not differ between groups. SA patients reported worsened 3-month post-treatment versus pre-treatment self-care (4.6 vs. 5.0), lifting light (4.6 vs. 5.0) and heavy (4.2 vs. 4.8) objects, overhead reach (4.5 vs. 4.9), activity (4.5 vs. 4.9), socialization (4.7 vs. 4.9), recreation (4.6 vs. 4.9), and overall score (86.8 vs. 95.3) (all p < 0.05). One-year post-treatment scores (n = 34) were no different than pre-treatment in all domains. S + a[C]XRT patients reported worsened 3-month versus pre-treatment stiffness (4.0 vs. 4.8), lifting heavy objects (3.8 vs. 4.9), overhead reach (4.2 vs. 4.9), socialization (4.6 vs. 5.0), recreation (4.4 vs. 4.9) and overall score (82.4 vs. 96.0) (all p < 0.05). One-year post-treatment scores (n = 13) were no different than pre-treatment in all domains. d[C]XRT patients reported worsened 3-month versus pre-treatment difficulty lifting heavy objects (4.3 vs. 4.7) and recreation (4.3 vs. 4.7). One-year posttreatment scores (n = 21) were no different than pre-treatment in all domains.

CONCLUSION:

HPV + OPSCC patients may experience mild shoulder/neck dysfunction 3 months after treatment that usually resolves by 1 year, independent of treatment modality.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Risk_factors_studies Idioma: En Revista: Clin Otolaryngol Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Risk_factors_studies Idioma: En Revista: Clin Otolaryngol Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos