Loh Sook Y, Mcleod Robert W J, Elhassan Hassan A
Cardiff University School of Medicine, Cardiff, UK.
Department of Otolaryngology, University Hospital of Wales, Cardiff, UK.
Eur Arch Otorhinolaryngol. 2017 Jul;274(7):2695-2707. doi: 10.1007/s00405-017-4519-6. Epub 2017 Mar 25.
The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include "oropharyngeal/head and neck cancer", "trismus/mouth opening" and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.
本综述的目的是系统比较治疗头颈癌（尤其是口咽癌）的不同干预措施之间牙关紧闭的主观测量结果。使用系统评价和荟萃分析的首选报告项目（PRISMA）指南，通过各种检索词在六个数据库中检索文本，这些检索词包括“口咽/头颈癌”“牙关紧闭/张口度”以及各种治疗方式。纳入综述的是临床研究（≥10例患者）。三位观察者独立评估所确定的论文。在所综述的六项研究中，五项研究表明，与单纯手术相比，放疗或手术加放疗（RT）±化疗或放化疗在生活质量问卷评分方面的结果明显更差。只有一项研究表明单纯手术与其他治疗方式之间没有显著差异。主观生活质量测量是现代外科实践的一个并行部分。尽管主观测量方法成功用于测量术后牙关紧闭情况，但对于哪种治疗方式总体效果更好尚无共识，相互矛盾的研究与该领域当前的争论一致。需要开展更大规模、更高质量的研究来比较所有三种治疗方式。
