Universidade Federal de Minas Gerais (UFMG), Pós-Graduação Em Ciências Fonoaudiológicas, Faculdade de Medicina, 190 Alfredo Balena Avenue, Santa Efigênia, Belo Horizonte City, Minas Gerais State, 30130-100, Brazil.
Instituto de Previdência Dos Servidores Do Estado de Minas Gerais (IPSEMG), IPSEMG Hospital, 225 Alameda Ezequiel Dias, Centro, Belo Horizonte City, Minas Gerais State, 30130-110, Brazil.
BMC Palliat Care. 2023 Oct 6;22(1):150. doi: 10.1186/s12904-023-01268-4.
Although oncological palliative care is increasingly being offered by multidisciplinary teams, there is still a lack of data about some symptoms handled by these teams, such as dysphagia, in patients with advanced cancer outside swallow regions. This study aimed to estimate the occurrence of dysphagia in prognosis studies of adults with advanced cancer outside the head, neck, and upper gastrointestinal tract, and to determine if there is an association with mortality.
A systematic review of studies that evaluated dysphagia and mortality was conducted (PROSPERO: CRD42021257172).
BVS, PubMed, CINAHL, Web of Science, and Scopus. Data between 2011 and 2023 were selected.
Among the 608 articles screened, only 14 were included, which covered different types of cancer, primarily Lung, and Genitourinary, Skin, Hematological, and Central Nervous System as well. Dysphagia demonstrated a variable frequency, and almost half of the studies found a percentage of dysphagia above 60%, appearing most as a symptom that affects health-related quality of life and prove to be a toxicity of treatment. The association between dysphagia and mortality was only evaluated in three articles that studied advanced lung cancer, in which, after controlling for covariates, swallowing disorders were associated with worse survival, with prevalences of dysphagia and hazard ratios of 78.5% (1.12 [1.04-1.20]), 4% (1.34 [1.28-1.35]), and 3% (1.40 [1.07-1.81]), respectively.
The occurrence of dysphagia in advanced cancer outside the head, neck, and upper GI tract is common, and there seems to be an association with significantly decreased survival in patients with advanced lung cancer.
尽管多学科团队越来越多地提供肿瘤姑息治疗，但仍缺乏有关这些团队处理的某些症状的数据，例如吞咽困难，在头颈部和上消化道以外的晚期癌症患者中。本研究旨在估计头、颈和上消化道以外的晚期癌症患者预后研究中吞咽困难的发生率，并确定其与死亡率之间是否存在关联。
对评估吞咽困难和死亡率的研究进行了系统评价（PROSPERO：CRD42021257172）。
BVS、PubMed、CINAHL、Web of Science 和 Scopus。选择了 2011 年至 2023 年的数据。
在筛选出的 608 篇文章中，仅纳入了 14 篇，涵盖了不同类型的癌症，主要为肺癌、泌尿生殖系统、皮肤、血液系统和中枢神经系统。吞咽困难的频率存在差异，近一半的研究发现吞咽困难的比例超过 60%，几乎都表现为影响健康相关生活质量的症状，并证明是治疗的毒性。只有三篇研究晚期肺癌的文章评估了吞咽困难与死亡率之间的关系，在这些文章中，在控制了协变量后，吞咽障碍与生存状况较差相关，吞咽困难的患病率和危害比分别为 78.5%（1.12[1.04-1.20]）、4%（1.34[1.28-1.35]）和 3%（1.40[1.07-1.81]）。
头、颈和上消化道以外的晚期癌症患者吞咽困难的发生率较高，在晚期肺癌患者中，似乎与生存率显著降低有关。
