Speech and Language Therapy, The Royal Marsden NHS Foundation Trust, London, UK.
Speech and Language Therapy Department, Imperial College Healthcare NHS Trust, London, UK.
Support Care Cancer. 2018 Feb;26(2):515-519. doi: 10.1007/s00520-017-3858-6. Epub 2017 Sep 2.
Dysphagia can occur in advanced lung cancer due to direct tumour invasion or nerve compression. Anti-cancer treatments and co-morbid conditions may also cause or compound dysphagic symptoms. Speech and language therapy (SLT), medical and surgical interventions are available to address dysphagic symptoms in patients with lung cancer, however, management options are not described in national guidelines. Given the potentially short prognoses for patients with lung cancer, the aim of care should be to reduce symptom burden and maximise quality of life (QOL). Central to that aim is the identification and treatment of swallowing difficulties.
This study sought to identify the prevalence and impact of dysphagia on QOL in patients with advanced lung cancer.
A single-site, prospective, exploratory study was undertaken. Previously validated patient-reported outcome measures of swallowing were used to identify the presence and impact of dysphagia on QOL: EAT-10 assessment and the SWAL-QOL assessment.
Seventy-two participants were recruited with 18.1% identified as having dysphagia on completion of the EAT-10 assessment. On further evaluation using the SWAL-QOL, compromised quality of life was noted with increased fatigue and meal time duration, difficulties with food selection and reduced eating desire. Frequent throat clearing, coughing and perceived pharyngeal stasis were reported.
Dysphagia is a potential symptom in advanced lung cancer which may impact QOL. Patients, carers and healthcare professionals should be aware of this so that early referral to SLT can be expedited. More robust prevalence and interventional studies are required to inform optimal management of this distressing condition.
由于直接肿瘤侵袭或神经压迫，晚期肺癌可出现吞咽困难。癌症治疗和合并症也可能导致或加重吞咽困难症状。言语和语言治疗（SLT）、医疗和手术干预可用于治疗肺癌患者的吞咽困难症状，但国家指南中并未描述管理选择。鉴于肺癌患者的预后可能较短，护理目标应是减轻症状负担并最大限度地提高生活质量（QOL）。这一目标的核心是识别和治疗吞咽困难。
本研究旨在确定晚期肺癌患者吞咽困难的患病率及其对生活质量的影响。
进行了一项单站点、前瞻性、探索性研究。使用经过验证的吞咽患者报告结局测量工具来识别吞咽困难的存在和对生活质量的影响：EAT-10 评估和 SWAL-QOL 评估。
共招募了 72 名参与者，其中 18.1%的参与者在完成 EAT-10 评估时被确定为存在吞咽困难。在进一步使用 SWAL-QOL 进行评估时，发现生活质量受损，疲劳和用餐时间延长，食物选择困难以及进食欲望降低。频繁清喉、咳嗽和咽部停滞感被报告。
吞咽困难是晚期肺癌的一种潜在症状，可能会影响生活质量。患者、护理人员和医疗保健专业人员应该意识到这一点，以便尽快向言语和语言治疗师转介。需要更有力的患病率和干预研究来为这一令人痛苦的疾病提供最佳管理。
