Qualidade de vida e análise funcional após o tratamento do câncer bucal: perspectivas para a reabilitação oral
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Data
2009-03-26
Autores
Pereira, Tatiana [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O tratamento do câncer bucal geralmente resulta em deficiências funcionais que afetam a qualidade de vida (QV). O objetivo deste estudo foi avaliar o impacto do tratamento do câncer bucal na QV, além de investigar as alterações funcionais e as perspectivas para a reabilitação oral. Cinqüenta pacientes foram recrutados entre abril e dezembro de 2008. O questionário da Universidade de Washington para portadores de câncer em cabeça e pescoço (UW-QOL) foi utilizado, e exames clínicos foram realizados. Os resultados foram comparados de acordo com idade, gênero, estadiamento TNM do tumor, localização, tratamento cirúrgico ou terapia combinada (cirurgia e radioterapia/ quimioterapia - Rt/Qt) dos pacientes. A amostra possuía 42 homens e 8 mulheres, com idade média de 60,5 anos, submetidos ao tratamento cirúrgico, sendo que 29 destes realizaram Rt/Qt adjuvante. O tratamento combinado foi associado à pior QV com relação aos domínios dor, deglutição, mastigação, paladar e saliva. A localização anatômica e o tamanho do tumor (estadiamento T) não influenciaram no tipo de tratamento. Problemas com a mobilidade da língua revelou baixos escores para a fala e para a mastigação. Câncer em rebordo alveolar demonstrou maior complexidade do ponto de vista reabilitador. Pacientes que desejavam tratamento reabilitador apresentaram problemas com mastigação, fala e paladar. Compreendendo os efeitos adversos, principalmente do tratamento combinado na QV e na função do paciente, torna-se importante avaliar as implicações de cada modalidade terapêutica e informar ao paciente sobre esses efeitos, para que ele possa exercer o direito de aceitar ou não determinada terapia. Considerando a mastigação e a deglutição como os principais problemas após o tratamento do câncer bucal, é possível concluir a importância do Cirurgião-Dentista no acompanhamento e reabilitação...
The treatment of oral cancer generally results in functional disorders and can affect the quality of life (QOL). The purpose of this study was to investigate the impact of the oral cancer treatment in the QOL and functional status, and to assess the perspectives for oral rehabilitation. Fifty patients treated for oral cancer were recruited between April to December 2008. The University of Washington Head and Neck Questionnaire (UW-QOL) and clinical examination were used, and the outcome was compared against patient‟s age, gender, TNM stage, anatomical site, surgical and adjuvant therapy. Fifty patients (42 men and 8 women), with mean age 60.5 years underwent surgery. Of 50 patients, 29 underwent adjuvant radiotherapy or chemotherapy (Rt/Ct). Adjuvant Rt/Ct was associated to worse QOL related to pain, swallowing, chewing, taste and saliva. The anatomical site and the size (T stage) of the tumour did not influence the type of treatment. Tongue mobility changes reflected in low scores for speech and chewing domains. Cancer on alveolar ridge will require more complex rehabilitation. Patients who wish the rehabilitation showed low scores in chewing, speech and taste. Understanding the side effects mainly of the combined treatments and how patients experience them as well as the functional and QOL implications is important to treatment evaluation and patient decision making. Considering the chewing and swallowing as the major complains after the oral cancer treatment is possible to conclude the importance of dentists on the follow up and rehabilitation of these patients. Yet oral rehabilitation of oral cancer patients has not been explored by dentists, who could work on the improvement of patient‟s QOL with the prosthodontic rehabilitation and maintenance of oral health. The real impact of oral rehabilitation in the QOL of patients after the oral cancer treatment has not been properly investigated.
The treatment of oral cancer generally results in functional disorders and can affect the quality of life (QOL). The purpose of this study was to investigate the impact of the oral cancer treatment in the QOL and functional status, and to assess the perspectives for oral rehabilitation. Fifty patients treated for oral cancer were recruited between April to December 2008. The University of Washington Head and Neck Questionnaire (UW-QOL) and clinical examination were used, and the outcome was compared against patient‟s age, gender, TNM stage, anatomical site, surgical and adjuvant therapy. Fifty patients (42 men and 8 women), with mean age 60.5 years underwent surgery. Of 50 patients, 29 underwent adjuvant radiotherapy or chemotherapy (Rt/Ct). Adjuvant Rt/Ct was associated to worse QOL related to pain, swallowing, chewing, taste and saliva. The anatomical site and the size (T stage) of the tumour did not influence the type of treatment. Tongue mobility changes reflected in low scores for speech and chewing domains. Cancer on alveolar ridge will require more complex rehabilitation. Patients who wish the rehabilitation showed low scores in chewing, speech and taste. Understanding the side effects mainly of the combined treatments and how patients experience them as well as the functional and QOL implications is important to treatment evaluation and patient decision making. Considering the chewing and swallowing as the major complains after the oral cancer treatment is possible to conclude the importance of dentists on the follow up and rehabilitation of these patients. Yet oral rehabilitation of oral cancer patients has not been explored by dentists, who could work on the improvement of patient‟s QOL with the prosthodontic rehabilitation and maintenance of oral health. The real impact of oral rehabilitation in the QOL of patients after the oral cancer treatment has not been properly investigated.
Descrição
Palavras-chave
Qualidade de vida, Radioterapia, Cirurgia, Neoplasias bucais, Diagnóstico bucal, Reabilitação bucal, Mouth neoplasms, Quality of life, Oral diagnosis, Mouth reahbilitation, Radiotherapy, Surgery
Como citar
PEREIRA, Tatiana. Qualidade de vida e análise funcional após o tratamento do câncer bucal: perspectivas para a reabilitação oral. 2009. 171 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Odontologia de Araraquara, 2009.