背景:尽管肿瘤姑息治疗越来越多地由多学科团队提供,这些团队处理的一些症状仍然缺乏数据,比如吞咽困难,在吞咽区域以外的晚期癌症患者中。本研究旨在评估成人头部外晚期癌症的预后研究中吞咽困难的发生。脖子,和上消化道,并确定是否与死亡率有关。
方法:对评估吞咽困难和死亡率的研究进行了系统评价(PROSPERO:CRD42021257172)。
方法:BVS,PubMed,CINAHL,WebofScience,还有Scopus.选择了2011年至2023年的数据。
结果:在筛选的608篇文章中,只包括14个,涵盖了不同类型的癌症,主要是肺,和泌尿生殖系统,皮肤,血液学,还有中枢神经系统.吞咽困难表现出可变的频率,几乎一半的研究发现吞咽困难的百分比超过60%,最多表现为影响健康相关生活质量的症状,并被证明是治疗的毒性。吞咽困难和死亡率之间的关联仅在三篇研究晚期肺癌的文章中进行了评估,其中,在控制协变量后,吞咽障碍与较差的生存有关,吞咽困难的发生率和危险比为78.5%(1.12[1.04-1.20]),4%(1.34[1.28-1.35]),和3%(1.40[1.07-1.81]),分别。
结论:头部外晚期癌症发生吞咽困难,脖子,上消化道很常见,并且似乎与晚期肺癌患者的生存率显着降低有关。
BACKGROUND: Although oncological palliative care is increasingly being offered by multidisciplinary teams, there is still a lack of data about some symptoms handled by these teams, such as dysphagia, in patients with advanced cancer outside swallow regions. This study aimed to estimate the occurrence of dysphagia in prognosis studies of adults with advanced cancer outside the head, neck, and upper gastrointestinal tract, and to determine if there is an association with mortality.
METHODS: A systematic
review of studies that evaluated dysphagia and mortality was conducted (PROSPERO: CRD42021257172).
METHODS: BVS, PubMed, CINAHL, Web of Science, and Scopus. Data between 2011 and 2023 were selected.
RESULTS: Among the 608 articles screened, only 14 were included, which covered different types of cancer, primarily Lung, and Genitourinary, Skin, Hematological, and Central Nervous System as well. Dysphagia demonstrated a variable frequency, and almost half of the studies found a percentage of dysphagia above 60%, appearing most as a symptom that affects health-related quality of life and prove to be a toxicity of treatment. The association between dysphagia and mortality was only evaluated in three articles that studied advanced lung cancer, in which, after controlling for covariates, swallowing disorders were associated with worse survival, with prevalences of dysphagia and hazard ratios of 78.5% (1.12 [1.04-1.20]), 4% (1.34 [1.28-1.35]), and 3% (1.40 [1.07-1.81]), respectively.
CONCLUSIONS: The occurrence of dysphagia in advanced cancer outside the head, neck, and upper GI tract is common, and there seems to be an association with significantly decreased survival in patients with advanced lung cancer.