Macfarlane Tatiana V, Wirth Tanja, Ranasinghe Sriyani, Ah-See Kim W, Renny Nick, Hurman David
School of Medicine and Dentistry, University of Aberdeen, Aberdeen United Kingdom.
School of Medicine and Dentistry, University of Aberdeen, Aberdeen United Kingdom. ; University of Bremen, Bremen Germany.
J Oral Maxillofac Res. 2012 Apr 1;3(1):e1. doi: 10.5037/jomr.2012.3101.
Pain is a major symptom in patients with cancer; however information on head and neck cancer related pain is limited. The aim of this review was to investigate the prevalence of pain and associated factors among patients with HNC.
The systematic review used search of MEDLINE, EMBASE and CINAHL databases to December 2011. Cancers of the oral mucosa, oropharynx, hypopharynx and larynx were included in this review with pain as main outcome. The review was restricted to full research reports of observational studies published in English. A checklist was used to assess the quality of selected studies.
There were 82 studies included in the review and most of them (84%) were conducted in the past ten years. Studies were relatively small, with a median of 80 patients (IQR 44, 154). The quality of reporting was variable. Most studies (77%) used self-administered quality of life questionnaires, where pain was a component of the overall scale. Only 33 studies reported pain prevalence in HNC patients (combined estimate from meta-analysis before (57%, 95% CI 43% - 70%) and after (42%, 95% CI 33% - 50%) treatment. Only 49 studies (60%) considered associated factors, mostly tumour- or treatment-related.
The study has shown high levels of pain prevalence and some factors associated with higher levels of pain. There is a need for higher quality studies in a priority area for the care of patients with head and neck cancer.
疼痛是癌症患者的主要症状；然而，关于头颈癌相关疼痛的信息有限。本综述的目的是调查头颈癌患者疼痛的患病率及相关因素。
本系统综述检索了截至2011年12月的MEDLINE、EMBASE和CINAHL数据库。本综述纳入口腔黏膜癌、口咽癌、下咽癌和喉癌，以疼痛作为主要结局。综述限于以英文发表的观察性研究的完整研究报告。使用清单评估所选研究的质量。
本综述纳入82项研究，其中大部分（84%）是在过去十年进行的。研究规模相对较小，患者中位数为80例（四分位间距44, 154）。报告质量参差不齐。大多数研究（77%）使用自我管理的生活质量问卷，疼痛是总体量表的一个组成部分。只有33项研究报告了头颈癌患者的疼痛患病率（治疗前荟萃分析合并估计值为57%，95%可信区间43% - 70%；治疗后为42%，95%可信区间33% - 50%）。只有49项研究（60%）考虑了相关因素，主要是肿瘤或治疗相关因素。
该研究显示疼痛患病率较高，且存在一些与较高疼痛水平相关的因素。对头颈癌患者护理的优先领域，需要开展更高质量的研究。
