Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Head and Neck Surgery Functional Outcomes & Assessment Laboratory (HNSFAL), Institute of Reconstructive Sciences in Medicine, University of Alberta, Edmonton, AB, Canada.
Dysphagia. 2020 Feb;35(1):18-23. doi: 10.1007/s00455-019-09996-7. Epub 2019 Mar 7.
Over the last two decades, dysphagia is increasingly recognized as a significant short-term and long-term issue in oropharyngeal cancer patients. However, there remains a lack of standardization and agreement about reporting swallowing outcomes in studies that assess treatment outcomes in this population. A systematic review was performed following PRISMA Guidelines by searching Pubmed (MEDLINE) and Scopus. The inclusion criteria used included (1) prospective and retrospective clinical studies involving adult patients with oropharyngeal cancer, (2) reports swallowing outcomes, (3) English studies or studies with English translation, (4) full text retrievable and (5) publication between 1990 and 2016. 410 unique studies were identified, and 106 were analyzed. A majority (> 80%) of studies that reported swallowing outcomes were published after 2010. While 75.4% of studies reported subjective outcomes (e.g., patient-reported or clinician-reported outcome measures), only 30.2% of studies presented results of objective instrumental assessment of swallowing. The majority (61%) of studies reported short-term swallowing outcomes at 1 year or less, and only 10% of studies examined 5-year swallowing comes. One study examined late-dysphagia (> 10 years) in the oropharyngeal cancer population. Considerable heterogeneity remains in the reporting of swallowing outcomes after treatment of oropharyngeal cancer despite its importance for quality of life. Studies reporting long-term swallowing outcomes are lacking in the literature, and objective measures of swallowing function remain underutilized and nonstandardized.
在过去的二十年中,吞咽困难越来越被认为是口咽癌患者的一个重要的短期和长期问题。然而,在评估该人群治疗效果的研究中,对于吞咽结果的报告仍然缺乏标准化和一致性。按照 PRISMA 指南进行了系统评价,检索了 Pubmed(MEDLINE)和 Scopus。使用的纳入标准包括:(1)涉及口咽癌成年患者的前瞻性和回顾性临床研究;(2)报告吞咽结果;(3)英文研究或有英文翻译的研究;(4)可全文获取;(5)发表时间在 1990 年至 2016 年之间。共确定了 410 篇独特的研究,其中 106 篇进行了分析。大多数(>80%)报告吞咽结果的研究发表于 2010 年之后。虽然 75.4%的研究报告了主观结果(例如,患者报告或临床医生报告的结果测量),但只有 30.2%的研究报告了吞咽的客观仪器评估结果。大多数(61%)研究报告了 1 年或更短期的短期吞咽结果,只有 10%的研究检查了 5 年的吞咽结果。一项研究检查了口咽癌患者的晚期吞咽困难(>10 年)。尽管口咽癌的吞咽结果对生活质量很重要,但在口咽癌治疗后,其报告仍存在很大的异质性。文献中缺乏长期吞咽结果的研究,吞咽功能的客观测量仍然未得到充分利用且不标准化。