Qualidade de vida e voz pós-radioterapia: repercussões para a fonoaudiologia
Quality of life and voice after radiotherapy: Speech therapy repercussions
Renata Jacob Daniel Salomão de Campos; Isabel Cristina Gonçalves Leite
Resumo
Tema: o tratamento radioterápico do câncer de cabeça e pescoço tem mostrado resultados importantes no controle da doença quando neoadjuvante ou mesmo concomitante à quimioterapia. Pesquisas apontam um aumento da sobrevida após 5 anos de tratamento do câncer de laringe, o que torna necessário e justifica os esforços realizados na reabilitação da comunicação dos pacientes, e destaca a presença do profissional de Fonoaudiologia na equipe de radioterapia.
Objetivo: descrever as sequelas com repercussão fonoaudiológica, tais como alterações na qualidade vocal e na qualidade de vida, associadas ao tratamento proposto para tumores de cabeça e pescoço, em especial aquelas originadas após a radioterapia.
Conclusão: Várias sequelas, agudas e crônicas, como rouquidão, odinofagia e afonia, que envolvem dificuldades na comunicação oral e/ou deglutição dos pacientes após o tratamento radioterápico em cabeça e pescoço, interfere de maneira direta na comunicação, deglutição e qualidade de vida dos pacientes. Os profissionais envolvidos no tratamento desse câncer, dentre eles o fonoaudiólogo, através do conhecimento sobre o tratamento e as fragilidades terapêuticas que comprometem a qualidade vocal e qualidade de vida desses pacientes, busca contribuir no processo de recuperação minimizando os danos causados pela doença e melhorando a condição de saúde do indivíduo.
Palavras-chave
Abstract
Background: radiotherapy for head and neck cancer has been important for disease control, both as neo-adjuvant and concomitant to chemotherapy. 5-year survival rates after larynx cancer have increased, justifying the efforts towards rehabilitation of patients` communication and highlighting the importance of the speech-language pathologist in the radiotherapy team. New scientific and therapeutic breakthroughs have turned organ preservation into a strong ally in head and neck cancer treatment.
Purpose: to show the speech-language-related sequelae, such as changes in vocal and life quality, related to treatment for head and neck tumors, especially those arising after radiotherapy.
Conclusion: many acute and chronic sequelae, such as hoarseness, odinophagy and aphony, involving difficulties in oral communication and/or swallowing in patients after neck and head radiotherapy treatment, interfering with communication, swallowing, and life quality of patients in a direct manner. The professionals involved with the treatment of this cancer, with the speech-language pathologist among them, through the knowledge on the treatment and its therapeutic weaknesses that jeopardize the vocal quality and life quality of those patients, seek to contribute in the recovery process in order to minimize damages caused by the disease and improving the individual's health condition.
Keywords
Referências
1. Behlau M. Voz o livro do especialista. Rio de Janeiro: Revinter; 2005.
2. Brasil. Ministério da Saúde. Secretaria de Assistência à Saúde. Instituto Nacional de Câncer. Câncer no Brasil: dados dos registros de base populacional. Rio de Janeiro: INCA; 2003.
3. Eksteen EC, Rieger J, Nesbitt M, Seikalv H. Comparison of voice characteristics following three different methods of treatment for laryngeal cancer. J Otolaryngol. 2003; 32(4):250-3.
4. Carrara-de EA, Furia CLB, Mourão LF, Kowalski LP. Atuação da fonoaudiologia no câncer de cabeça e pescoço. São Paulo: Lovise; 2000.
5. Dedivitis RA, França CM, Mafra ACB, Guimarães FT, Guimarães AV. Características clínico-epidemiológicas no carcinoma espinocelular de boca e faringe. Rev Bras Otorrinolaringol. 2004; 1(70):35-40.
6. Alho OP, Hannula K, Luokkala A, Teppo H, Koivunen P, Kantola S. Differential prognostic impact of comorbidity in head and neck cancer. Head Neck. 2007; 29(10):913-8.
7. Hendry JH, Branislay J, Zubizarreta EH. Normal tissue complications after radiation therapy. Rev Panam Salud Publica. 2006; 20(2/3):151-60.
8. Brasil. Ministério da Saúde. Instituto Nacional de Câncer. Carcinoma epidermóide de cabeça e pescoço. Condutas do INCA/MS. Rev Bras Cancerol. 2001; 47(4):361-76.
9. Almeida FCS, Cazal C, Durazzio MD, Ferraz AR, Silva DP. Radioterapia em cabeça e pescoço: efeitos colaterais agudos e crônicos bucais. Rev Bras Patol Oral. 2004; 3(2):62-9.
10. Prepageran N, Raman R. Delayed complication of radiotherapy: laryngeal fibrosis and bilateral vocal cord immobility. Med J Malaysia. 2005; 60(3):377-8.
11. Tschudi D, Steckli S, Schmid S. Quality of life after different treatment modalities for carcinoma of the oropharynx. Laryngoscope. 2003; 113:1949-54.
12. Caminero CMJ, Señaris GB, López LA, Núñez BF, Alonso PR, Suárez NC. Voice quality assessment after laryngeal cancer radiotherapeutic treatment at initial stages. Clin Transl Oncol. 2006; 8(4):284-9.
13. Dubois MD, Crevier-Buchman L, Martin C, Prades JM. Epidermoid carcinoma of piriform sinus after chemo-radiotherapy: acoustic evaluation and voice handicap. Rev Laryngol Otol Rhinol. 2006; 127(5):299-304.
14. Vickery LE, Latchford G, Hewison J, Bellew M, Feber T. The impact of head and neck cancer and facial disfigurement on the quality of life of patients and their partners. Head Neck. 2003; 25(4):289-96.
15. Behlau, M, Santos, LMA, Oliveira, G.. Cross-Cultural Adaptation and Validation of the Voice Handicap Index Into Brazilian Portuguese. J Voice. No prelo 2009
16. Jacobson BH, Johson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS. The voice Handicap Index (VHI); Development and validation. Am J Speech Lang Pathol 1997; 6:66-9.
17. Jotz GP, Dornelles S. Auto-avaliação da voz: voice handicap index. Arq Med Canoas. 2000; 3:43-50.
18. Vartanian JG, Carvalho AL, Yueh B, Furia CLB, Toyota J, Mcdowell JA et al. Brazilian–portuguese validation of the University of Washington quality of life questionnaire for patients with head and neck cancer. Published online 5 July 2006 in Wiley InterScience. Disponível em: http://www.interscience.wiley.com. Acesso em 02 de novembro de 2007.
19. Van Goch CD, Verdonck-De Leeuww M, Boon-Kamma BA, Rinkel RN, De Bruin MD, Langendijk JA, et al. The efficacy of voice therapy in patients after treatment for early glottic carcinoma. Cancer. 2006; 106(1):95-105.
20. Peeters AJ, Van Gogh CD, Goor KM, Verdonck-De Leeuw IM, Langendijk JA, Mahieu HF. Health status and voice outcome after treatment for T1a glottic carcinoma. Eur Arch Otorhinolaryngol. 2004; 261(10):534-40.
21. Olthoff A, Steuer-Vogt MK, Licht K, Sauer-Goenen M, Werner C, Ambrosch P. Quality of life after treatment for laryngeal carcinomas. J Otorhinolaryngol – Relate Spec. 2006; 68(5):253-8.
22. Goldstein DP, Hynds KL, Christensen AJ, Funk GF. Health-related quality of life profiles based on survivorship status for head and neck cancer patients. Head Neck. 2007; 29(3):221-9.
23. Verdonck-De Leeuw IM, Eerenstein SE, Van Der Linden MH, Kuik DJ, De Bree R, Leemans CR. Distress in spouses and patients after treatment for head and neck cancer. Laryngoscope. 2007;117(2):238-41.
Submetido em:
28/05/2009
Aceito em:
03/02/2010
Facebook
Twitter
LinkedIn
Mendeley
Email