口腔护理对头颈部癌症结局的影响：系统评价和荟萃分析。

The Impact of Dental Care in Head and Neck Cancer Outcomes: A Systematic Review and Meta-Analysis.

机构信息

Department of Otolaryngology -Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.

Banner MD Anderson Cancer Center, Gilbert, Arizona, U.S.A.

出版信息

Laryngoscope. 2022 Jan;132(1):45-52. doi: 10.1002/lary.29494. Epub 2021 Feb 26.

DOI:10.1002/lary.29494

PMID:33635587

Abstract

OBJECTIVE/HYPOTHESIS: The objective of this study was to perform a systematic review and meta-analysis to determine the impact of dental care on head and neck (H&N) cancer survival.

METHODS

A comprehensive literature search was performed using PubMed, MEDLINE, and CINAHL to find all relevant studies from the date of inception to March 2020. Systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and meta-analysis was performed using the random effects logistic regression model. Primary outcomes of interest were 5-year survival and hazard ratios comparing survival between dental care subgroups.

RESULTS

H&N cancer survival rates strongly correlate with dental care adherence. Patients with good dental care had significantly better survival than patients with poor dental care (HR = 0.67, 95% CI: 0.55-0.83), with similar improved survival among patients with moderate versus poor dental care (HR = 0.67, 95% CI: 0.57-0.80). In addition, patients with good dental care had significantly decreased mortality than those with moderate dental care (HR = 0.81, 95% CI: 0.69-0.96), indicating an exposure-response gradient.

CONCLUSIONS

For patients with H&N cancer, survival is significantly higher in those who receive recommended dental care compared with those who do not.

LEVEL OF EVIDENCE

NA Laryngoscope, 132:45-52, 2022.

摘要

目的/假设：本研究的目的是进行系统评价和荟萃分析，以确定口腔护理对头颈部（H&N）癌症生存的影响。

方法

使用 PubMed、MEDLINE 和 CINAHL 进行全面的文献检索，以查找从成立日期到 2020 年 3 月的所有相关研究。系统评价按照系统评价和荟萃分析报告的首选项目进行，荟萃分析使用随机效应逻辑回归模型进行。主要观察结果是 5 年生存率和比较口腔护理亚组之间生存率的危险比。

结果

H&N 癌症的生存率与口腔护理的依从性密切相关。口腔护理良好的患者比口腔护理不良的患者的生存率显著提高（HR=0.67，95%CI：0.55-0.83），口腔护理中等的患者比口腔护理不良的患者的生存率也有类似的提高（HR=0.67，95%CI：0.57-0.80）。此外，口腔护理良好的患者的死亡率显著低于口腔护理中等的患者（HR=0.81，95%CI：0.69-0.96），表明存在暴露-反应梯度。