Postural Changes Caused by Antineoplastic Treatment for Head and Neck Neoplasms
DOI:
https://doi.org/10.21270/archi.v13i7.6334Palavras-chave:
Head and Neck Neoplasms, Radiotherapy, Postural BalanceResumo
Background: Loss or reduction of muscle function in the cervical and scapular region, causing mobility limits, trismus, and postural abnormalities, are a common musculoskeletal change reported in head and neck cancer (HNC) survivors, with limited information in the scientific literature. Aim: This study aims to describe the patients’ overall posture after antineoplastic treatment and verify possible musculoskeletal complications as well as general body posture and its association with temporomandibular disorder (TMD)/orofacial pain (OFP) and quality of life. Methods: The study included patients suffering from head and neck cancer (HNC) after antineoplastic therapy. The following variables were evaluated: body posture photogrammetry, signs and symptoms of TMD and OFP, trismus, and overall quality of life. Results: The study included 60 individuals diagnosed with HNC. Photogrammetry evaluation showed significant differences for shoulder asymmetry (p=0.02), changes between the pelvic waist and knee joint (p=0.04), and changes in the cervical spine (p=0.01). For the variables related to TMD and OFP, were found pain in the masseter muscle, presence of “cracking sound” in the temporomandibular joint, difficulty and limitation for mouth opening, with and without pain, trismus, difficulty for speaking or chewing, and pain surrounding the ears and temples. For quality of life, there were differences for the following dimensions: functional capacity, physical aspects, limitation and pain. Conclusions: Postural evaluation has shown that antineoplastic treatment causes musculoskeletal disorders which alter normal posture, not only in regions directly affected by treatment, but also in several areas of the body, thereby negatively impacting the quality of life.
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Brouwer CL, Steenbakkers RJ, Langendijk JA, Sijtsema NM. Identifying patients who may benefit from adaptive radiotherapy: Does the literature on anatomic and dosimetric changes in head and neck organs at risk during radiotherapy provide information to help? Radiother Oncol. 2015;115(3):285-94
Chen YY, Zhao C, Wang J, Ma HL, Lai SZ, Liu Y, Han F, Lu LX, Bao Y, Chen M. Intensity-modulated radiation therapy reduces radiation-induced trismus in patients with nasopharyngeal carcinoma: a prospective study with >5 years of follow-up. Cancer. 2011;117(13):2910-16.
Ning Y, Wang Q, Ding Y, Zhao W, Jia Z, Wang B. Barriers and facilitators to physical activity participation in patients with head and neck cancer: a scoping review. Support Care Cancer. 2022;30(6):4591-601.
Strojan P, Hutcheson KA, Eisbruch A, Beitler JJ, Langendijk JA, Lee AWM, Corry J, Mendenhall WM, Smee R, Rinaldo A, Ferlito A. Treatment of late sequelae after radiotherapy for head and neck cancer. Cancer Treat Rev. 2017;59:79-92.
Bossi P, Giusti R, Tarsitano A, Airoldi M, De Sanctis V, Caspiani O, Alterio D, Tartaro T, Alfieri S, Siano M. The point of pain in head and neck cancer. Crit Rev Oncol Hematol. 2019;138:51-9.
de Bree R, van Beers MA, Schaeffers AWMA. Sarcopenia and its impact in head and neck cancer treatment. Curr Opin Otolaryngol Head Neck Surg. 2022;30(2):87-93.
Ghiam MK, Mannion K, Dietrich MS, Stevens KL, Gilbert J, Murphy BA. Assessment of musculoskeletal impairment in head and neck cancer patients. Support Care Cancer. 2017;25(7):2085-92.
Rolim AEH, Costa LJ, Ramalho LMP. Impact of radiotherapy on the orofacial region and management of related conditions. Radiol Bras. 2011;44(6):388-95.
Wahl MJ. Osteoradionecrosis prevention myths. Int J Radiat Oncol Biol Phys. 2006;64:661-669.
Murphy BA. Advances in supportive care for late effects of head and neck câncer. J Clin Oncol. 2015;33:3314-321.
Wilgen CPV, Dijkstra PU, Van der Laan BFAM. Morbidity of the neck after head and neck cancer therapy. Head Neck. 2004;26:785-91.
Wouwe MV, Bree R, Kuik DJ. Shoulder morbidity after non-surgical treatment of the neck. Radiother Oncol. 2009;90:196-201.
Rocabado M, Jhonston BE, Blakney MG. Physical therapy and Dentistry: an overview. J cranium and practice. 1982;1:46-9.
Urbanowicz M. Alteration of vertical dimension and its effects on head and neck posture. J Cranimand Practice. 1991;9:174-79.
Sacco ICN, Alibert S, Queiroz BWC. Confiabilidade da fotogrametria em relação a goniometria para avaliação postural de membros inferiores. Rev. Bras. Fisioter. 2007;11:411-17.
Andrade RM, Guimarães LR, Ribeiro A, Marques AP, Crivello O, Carvalho BKG, Amado JSM. Reliability in Mandibular Movement Evaluation Using Photogrammetry in Patients With Temporomandibular Disorders. J Manipulative Physiol Ther. 2019;42: 267-75.
Kendal FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. Muscles: Testing and Function, with Posture and Pain. Baltimore: Lippincott Williams & Wilkins, 2005.
Kulczynski FZ, Andriola FO, Deon PH, Melo DAS, Pagnoncelli RM. Postural assessment in class III patients before and after orthognathic Surgery. J Oral Maxillofac Surg. 2018; 76:426-35.
Pereira Júnior FJ, Favilla EE, Dworkin S, Huggins K. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): formal translation to portuguese. Tradução oficial para a língua portuguesa. J Bras Clin Odontol Integr. 2004;8:384-95.
Dijkstra PU, Huisman PM, Roodenburg JLM. Criteria for trismus in head and neck oncology. Int J Oral Maxillofac Surg. 2006;35:337-42.
Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev Bras Reumatol. 1999;39:143-50.
Grégoire V, Langendijk JA, Nuyts S. Advances in Radiotherapy for Head and Neck Cancer. J Clin Oncol. 2015;33:1-9.
Gane EM, McPhail SM, Hatton AL, Panizza BJ, O’Leary SP. The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection. J Cancer Surviv. 2018;12:619-63.
Gane EM, Michaleff ZA, Cottrell MA, McPhail SM, Hatton AL, Panizza BJ, O’Leary SP. Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: a systematic review. Eur J Surg Oncol. 2017;43:1199– 218.
Panos RL, Ortiz-Gutiérrez RM, Valero PC, Concepción EF. Valoración del control postural y del equibrio em personas con transtornos temporomandibulares: revisión sistemática. Rehabilitación. 2019;53:28-42.
Moradi N, Maroufi N, Bijankhan M, Nik TH, Salavat M, Jalayer T, Yazdi MJS, Ghasemi S, Soltani M, Naderifar E et al. Intrarater and interrater reliability of sagittal head posture: a novel technique perfomed by a physiotherapist and a speech and language pathologist. J Voice. 2014;28:842.
Bhatia K, King AD, Paunipagar BK, Abrigo J, Vlantis AC, Leung SF, Ahuja AT. MRI finding in patients with severe trismus following radiotherapy for nasopharyngeal carcinoma. Eur Radiol. 2009;19: 2586-593.
Klasser GD, Epstein JB, Utsman R. Parotid gland squamous cell carcinoma invading the temporomandibular joint. J Am Dent Assoc. 2009;140:992-99.
O’Sullivan B, Rumble RB, Warde P. Intensity- modulated radiotherapy in the treatment of head and neck cancer. Clin Oncol. 2012;24:474-87.
Rapidis AD, Dijkstra PU, Roodenburg JLN, Rodrigo JP, Rinaldo A, Strojan P, Takes RP, Ferlito A. Trismus in patients with head and neck cancer: etiopathogenesis, diagnosis and management. Clin Otolaryngol. 2015;40:516-26.
Wu VW1, Lam YN 2016 Radiation-induced temporomandibular joint disorder in post- radiotherapy nasopharyngeal carcinoma patients: assessment and tratament. 2016;63(2):124-32.
White K, D’Abrew N, Katris P, O’Connor M, Emery L. Mapping the psychosocial and practical support needs of cancer patients in Western Australia. Eur J Cancer Care. 2012;21:107–16.
Ferreira, PL. Creation of Portuguese version of the MOS SF-36 Part 1, Cultural and Linguistica. Acta Med Port. 2000;13:55-66.
Tahani B, Razavi SM, Emami H, Alamchi F;Assessment of the quality of life of the patients with treated oral cancer in Iran. Oral Maxillofac Surg. 2017; 21:429-34