舌癌患者における切除部位に応じた口腔機能とQOLの変化について

Changes in Oral Function and Quality of Life in Tongue Cancer Patients Based on Resected Area.

抄録

目的:

舌癌の治療では，口腔乾燥や嚥下障害などの口腔障害が生じる．本研究の目的は、舌癌切除後の患者の口腔機能とQOLの時間経過を切除部位に基づいて検討することである。

OBJECTIVE: Treatment of tongue cancer caused oral morbidities such as oral dryness, and dysphagia. The purpose of this study is to examine the time course of oral function and QOL based on resected area for patients after tongue cancer resection.

方法:

METHODS: 31 patients who underwent tongue cancer resection at the Showa University Head and Neck Oncology Center. The participants were divided into two groups; 24 participants in partial/hemi glossectomy group (PG), and seven in subtotal/total glossectomy group (TG). Participants were evaluated swallowing function (FOIS and MASA-C), tongue pressure (TP: kPa), BMI, whole body muscle mass (kg), and QOL evaluation (EORTC QLQ-C30, H & N35). Participants were measured at baseline (before surgical treatment), 1, 3, and 6 months after surgical treatment (1M, 3M, and 6M).

結果:

ベースラインでは、PGの舌圧とFOISスコアはTGよりも有意に高かった。1Mでは、PGのTP、MASA-C、FOISスコアはTGよりも有意に高かった。3Mでは、PGのTP、MASA-C、FOISスコアはTGよりも有意に高かった。6Mでは、TPとMASA-CがTGよりも有意に高かった。6M前のQOL測定では、両群間に有意差は認められなかった。6Mの時点で、舌の機能（嚥下、感覚、発声、社会的接触）に関連するいくつかのQOL測定値は、TGがPGよりも有意に低かった。

RESULTS: At baseline, tongue pressure and FOIS score of PG were significant higher than that of TG. At 1M, TP, MASA-C, and FOIS score of PG were significant higher than that of TG. At 3M, TP, MASA-C, and FOIS score of PG were significant higher than that of TG. At 6M, TP and MASA-C were significantly higher than that of TG. QOL measurements did not noted any significant difference between groups before 6M. At 6M, Some QOL measurements of TG related tongue function (Swallowing, Senses, Speech, Social contact) were significantly lower than PG.

結論:

切除した部位は口腔内の病状や摂食機能に大きな影響を与えた。機能障害が残った患者のQOLを向上させるためには、より効果的なリハビリテーション方法を開発する必要があると考えられる。<br />。

CONCLUSIONS: The resected area had significant effects on oral morbidities and feeding function. It is necessary to develop more effective rehabilitation methods to improve patients QOL who had functional impairment remained.<br />.