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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Evaluation of a speech pathology service delivery model for patients at low dysphagia risk during radiotherapy for HNC
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Evaluation of a speech pathology service delivery model for patients at low dysphagia risk during radiotherapy for HNC

机译：HNC放射治疗期间低吞咽风险患者语音病理服务交付模型的评价

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Purpose There are no evidence-based guidelines informing which patients with head and neck cancer (HNC) require regular speech pathology (SP) support during radiation treatment (RT). Hence, some services use a "one-size-fits-all" model, potentially over-servicing those patients at low risk for dysphagia. This study evaluated the clinical safety and efficiency of an interdisciplinary service model for patients identified prospectively as "low risk" for dysphagia during RT. Methods A prospective cohort of 65 patients with HNCs of the skin, thyroid, parotid, nose, and salivary glands, receiving curative RT, were managed on a low-risk pathway. Patients with baseline dysphagia (functional oral intake score <= 5) were excluded. The model involved dietitians conducting dysphagia screening at weeks 3, 5, and 6/7 within scheduled appointments. Patients at risk of dysphagia were referred to SP for assessment, then management if required. To validate the model, SP assessed swallow status/toxicities at week 5/6/7 during RT and confirmed dysphagia status at weeks 2 and 6 post RT. Results Most (89.3%) patients did not require dysphagia support from SP services. Of the 18 patients identified on screening, only 7 (10.7%) had sufficient issues to return to SP care. Week 5/6/7 SP review confirmed low levels of toxicity. No post-treatment dysphagia was observed. There was an incremental benefit of A$15.02 for SP staff costs and a recovery of 5.31 appointments per patient. Conclusion The pathway is a safe and effective service model to manage patients with HNC at low risk for dysphagia during RT, avoiding unnecessary SP appointments for the patient and service.
机译：目的没有基于证据的准则，通知头部和颈部癌症（HNC）的患者在放射治疗（RT）期间需要定期语音病理（SP）支持。因此，有些服务使用“单尺寸适合 - 所有”模型，可能超过吞咽困难风险低的患者。本研究评估了在室温下吞咽困难症患者鉴定为“低风险”的患者跨学科服务模型的临床安全性和效率。方法对皮肤，甲状腺，腮腺，鼻子和唾液腺，接受治疗RT的前瞻队列的65例，接受治疗RT，在低风险途径上进行管理。患有基线吞咽困难（功能性口服摄入量<= 5）的患者被排除在外。该模型涉及在预定的时间内3,5和6/7的营养师进行吞咽筛查。患有障碍风险的患者被称为SP进行评估，然后在需要的情况下进行管理。为了验证模型，SP在第5/6/7周内评估吞咽状态/毒性，并在第2周和第6周内确认吞咽困难状态。结果大多数（89.3％）患者不需要SP服务的吞咽支持。在筛查的18名患者中，只有7名（10.7％）有足够的问题来返回SP护理。第5/6/7周SP审查确认毒性低。没有观察到治疗后吞咽症。 SP员工成本为15.02美元的增量效益，每位患者的预约5.31次。结论途径是一种安全有效的服务模型，可在RT期间以低风险管理HNC的患者，避免为患者和服务提供不必要的SP约会。

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