口咽吞咽困难与恶病质：头颈癌中的相互关联。
Oropharyngeal dysphagia and cachexia: Intertwined in head and neck cancer.
作者信息
Willemsen Anna C H, Pilz Walmari, Hoeben Ann, Hoebers Frank J P, Schols Annemie M W J, Baijens Laura W J
机构信息
GROW School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands.
Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.
出版信息
Head Neck. 2023 Apr;45(4):783-797. doi: 10.1002/hed.27288. Epub 2022 Dec 30.
BACKGROUND
This study aims to investigate the relationship between cancer cachexia and oropharyngeal dysphagia (OD) in patients with head and neck cancer (HNC) prior to chemoradiotherapy or bioradiotherapy (CRT/BRT).
METHODS
A prospective cohort study with patients with HNC undergoing CRT/BRT (2018-2021) was conducted. Body composition and skeletal muscle function were evaluated using bioelectrical impedance analysis, handgrip strength, and the short physical performance battery (SPPB). The M. D. Anderson Dysphagia Inventory (MDADI), Eating Assessment Tool (EAT)-10 questionnaire, and patient characteristics were collected. A standardized videofluoroscopic swallowing study was offered to patients.
RESULTS
Sixty-six patients were included. Twenty-six patients scored EAT-10 ≥ 3 and seventeen were cachectic. ACE-27 score >1, cachexia, abnormal SPPB-derived repeated chair-stand test, lower MDADI scores, and higher overall stage grouping showed potential predictive value (p ≤ 0.10) for EAT-10 ≥ 3. Using multivariable regression analysis, only cachexia remained a significant predictor of EAT-10 ≥ 3 (HR 9.000 [95%CI 2.483-32.619], p = 0.001).
CONCLUSION
Cachexia independently predicted the presence of patient-reported OD.
背景
本研究旨在调查头颈部癌（HNC）患者在放化疗或生物放疗（CRT/BRT）之前，癌症恶病质与口咽吞咽困难（OD）之间的关系。
方法
对2018年至2021年间接受CRT/BRT的HNC患者进行了一项前瞻性队列研究。使用生物电阻抗分析、握力和简短体能状况量表（SPPB）评估身体成分和骨骼肌功能。收集了MD安德森吞咽困难量表（MDADI）、进食评估工具（EAT）-10问卷和患者特征。为患者提供了标准化的视频透视吞咽研究。
结果
纳入66例患者。26例患者EAT-10评分≥3，17例为恶病质。ACE-27评分>1、恶病质、SPPB衍生的重复椅子站立试验异常、较低的MDADI评分和较高的总体分期分组对EAT-10≥3显示出潜在的预测价值（p≤0.10）。使用多变量回归分析，只有恶病质仍然是EAT-10≥3的显著预测因素（HR 9.000 [95%CI 2.483-32.619]，p = 0.001）。
结论
恶病质独立预测患者报告的OD的存在。
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