Authors (including presenting author) :
Yeung PS (1), Chan CS(1), Lui NF(1), Lai HW(1), Tang KL(1), Tsang YN(1), Tse KK(1), Leung KC(2)
Affiliation :
(1)Occupational Therapy Department, Queen Elizabeth Hospital
(2)Department of Clinical Oncology, Queen Elizabeth Hospital
Introduction :
Nasopharyngeal cancer (NPC) is a common disease in Hong Kong. The mainstay of treatment is radiotherapy (RT) as the tumor cells are highly radiosensitive. Complications of RT are well documented. However, there is limited data in the literature regarding pre-treatment, early post treatment and long term post treatment effect after treatment.
Starting from Oct 2012 onwards, Occupational therapists in QEH provides early prehabilitation services to these groups of patients. These include disease management education, on-going swallowing assessment and monitoring, swallowing training and advice, anti-trismus and neck exercise. The aim was to provide early screening and monitoring of the RT complications, to coach patients along the journey of disease, and to facilitate them to engage in the rehabilitation program.
Objectives :
The objective of this review are 1) was to reveal the incidence and type of swallowing dysfunction in those patients, early before treatment and long term post treatment 2) Quality of life within first year after RT 3) the long term risk of aspiration, so as to justify the effectiveness of the swallowing assessment and intervention program.
Methodology :
Patients who newly diagnosed with NPC were referred to receive pre- and post RT assessment with regular 1 year follow up. Patients have completed 6 years of monitoring were recruited in this review.
Result & Outcome :
33 patients reviewed with IMRT over 6 years period, with average age of 52.5. All patients report xerostomia immediate post RT. With 97.5% report xerostomia after 12month post RT. 65.1% report choking immediate after RT. 67.5% patients report choking after 12month post RT.
In jaw opening aspect, along the 6 years of monitoring, the average decrease is around 5mm.
In the aspect of quality of life, 4.3/ 7 immediate post RT. Increase to 5.1/7 at 12 month post RT.
With the ongoing monitoring and advise to the patients. Although oro-motor impairment gradually increases later in the year post RT. The dental gap well maintains with average decrease of 5mm. And the quality of life of the patients gradually improve post RT, with the continuous support and exercise given by the occupational therapist.
