Kenny Ciarán, Gilheaney Órla, Walsh Declan, Regan Julie
Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Harold's Cross, Dublin 6W, Ireland.
School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
Dysphagia. 2018 Jun;33(3):303-320. doi: 10.1007/s00455-018-9892-9. Epub 2018 Apr 2.
Dysphagia is often associated with head and neck and upper gastrointestinal (GI) tract cancers. Evidence suggests that those with solid malignancies in other primary sites may also have swallowing difficulties. Timely and accurate identification of dysphagia is important given the impact it has on hydration, medical treatment, nutrition, prognosis, and quality of life. A systematic review was conducted to identify swallow screening, evaluation, and quality of life tools for those with solid malignancies outside the head and neck and upper GI tract. Ten electronic databases, one journal and two published conference proceedings were searched. Following deduplication, 7435 studies were examined for relevance. No tools were validated solely in this cancer population, though some included this group in larger cohorts. Comments are provided on the diagnostic properties and applicability of these tools. In the absence of appropriate diagnostic instruments, the exact prevalence of dysphagia and its impact on clinical and psychosocial well-being remain unknown. Accurate and adequate measurement of therapeutic intervention is also compromised. This review establishes the need for validated dysphagia evaluation tools for this clinical population.
吞咽困难常与头颈部及上消化道（GI）癌症相关。有证据表明，其他原发部位患有实体恶性肿瘤的患者也可能存在吞咽困难。鉴于吞咽困难对水合作用、医学治疗、营养、预后及生活质量的影响，及时准确地识别吞咽困难十分重要。开展了一项系统综述，以确定针对头颈部及上消化道以外患有实体恶性肿瘤患者的吞咽筛查、评估及生活质量工具。检索了十个电子数据库、一份期刊及两份已发表的会议论文集。在去除重复项后，对7435项研究进行了相关性审查。虽然有些工具在更大的队列中纳入了这一癌症群体，但没有工具仅在这一癌症群体中得到验证。对这些工具的诊断特性及适用性进行了评论。由于缺乏合适的诊断工具，吞咽困难的确切患病率及其对临床和心理社会福祉的影响仍然未知。治疗干预的准确充分测量也受到影响。本综述确定了针对这一临床群体的经过验证的吞咽困难评估工具的必要性。
