Intérêt d’une prise en charge orthophonique des cancers ORL pendant la radio-chimiothérapie

Abstract : Our objectives were to develop a rehabilitation protocol for radiotherapy-treated patients with head or neck cancers and to evaluate the efficiency of this protocol to reduce swallowing and voice disorders induced by the radiotherapy.
Seven patients following this daily rehabilitation protocol for 7 weeks (« Protocol » group) were compared to six patients with comparable profiles (« Control » group). During the 7 weeks of radiotherapy, the « Protocol » group received, in parallel, our protocol consisting in voice and swallowing exercises. To evaluate the effects of this protocol, we analyzed the DHI and VHI self-assessments, respectively for swallowing and voice disorders and used a perceptual evaluation using the GRBAS scale.
The results of this study showed patients following the protocol exhibit reduced swallowing disorders compared to control patients, regardless the location of the tumor. In patients with pharyngeal cancer only, worsening of voice troubles seems to be reduced using this protocol. These observations extend to all patients when voice troubles were quantified using the GRBAS scale. The protocol also has positive impacts on the patient’s quality of life. However, some factors such as the kind of treatment (with or without chemotherapy) and the use of gastrostomy have influenced the results of this study.
In general, this work shows that an early intervention might slow down worsening of functional disorders during radiotherapy. Thus, revision of the rehabilitation protocol might be beneficial for the patients.
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Emmeline Giraud, Aude Tessier. Intérêt d’une prise en charge orthophonique des cancers ORL pendant la radio-chimiothérapie. Sciences cognitives. 2018. ⟨dumas-02084337⟩

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