Fabian Alexander, Domschikowski Justus, Hoffmann Markus, Weiner Oliver, Schmalz Claudia, Dunst Jürgen, Krug David
Department of Radiation Oncology, University Hospital Schleswig-Holstein, Kiel, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.
Front Oncol. 2021 Jun 4;11:683042. doi: 10.3389/fonc.2021.683042. eCollection 2021.
Incurable head and neck cancer has a poor prognosis and impairs a patient's health-related quality of life. Palliative radiotherapy may improve or stabilize health-related quality of life and symptoms, best measured by patient-reported outcomes. There is no systematic analysis if palliative radiotherapy for head and neck cancer improves or stabilizes health-related quality of life or symptoms as validly measured by patient-reported outcomes. Therefore, the primary objective of this systematic review (PROSPERO-ID: CRD42020166434) was to assess the effect of palliative radiotherapy for head and neck cancer on patient-reported outcomes. The secondary objective was to assess the rate and quality of use of patient-reported outcomes in relevant studies claiming a "palliative effect" of radiotherapy. The databases MEDLINE/PubMed, EMBASE, Cochrane CENTRAL, "ClinicalTrials.gov" were searched. Concerning the primary objective, four studies were eligible to assess the effectiveness of palliative radiotherapy as measured by patient-reported outcomes. A narrative synthesis suggests a favorable impact of palliative radiotherapy on health-related quality of life and symptom burden. The risk of bias, however, is considerable and the overall quality of evidence low. Concerning the secondary objective, over 90% of studies claiming a "palliative effect" of palliative radiotherapy did either not use patient-reported outcomes or did so by limited quality. In conclusion, implementation of patient-reported outcomes in studies assessing palliative radiotherapy for head and neck cancer should be fostered. Palliative radiotherapy remains an option for head and neck cancer patients, although more studies focusing on patient-reported outcomes are needed.
https://www.crd.york.ac.uk/prospero/, identifier CRD42020166434.
无法治愈的头颈癌预后较差，会损害患者与健康相关的生活质量。姑息性放疗可能改善或稳定与健康相关的生活质量及症状，通过患者报告结局来衡量最为合适。目前尚无系统分析表明，针对头颈癌的姑息性放疗能否改善或稳定由患者报告结局有效衡量的与健康相关的生活质量或症状。因此，本系统评价（PROSPERO编号：CRD42020166434）的主要目的是评估姑息性放疗对头颈癌患者报告结局的影响。次要目的是评估在声称放疗具有“姑息作用”的相关研究中，患者报告结局的使用频率和质量。检索了MEDLINE/PubMed、EMBASE、Cochrane CENTRAL、“ClinicalTrials.gov”等数据库。关于主要目的，有四项研究符合条件，可评估以患者报告结局衡量的姑息性放疗的有效性。叙述性综合分析表明，姑息性放疗对与健康相关的生活质量和症状负担有积极影响。然而，偏倚风险相当大，证据的总体质量较低。关于次要目的，超过90%声称姑息性放疗具有“姑息作用”的研究要么未使用患者报告结局，要么使用质量有限。总之，应促进在评估头颈癌姑息性放疗的研究中采用患者报告结局。姑息性放疗仍是头颈癌患者的一种选择，不过需要更多关注患者报告结局的研究。
