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基于证据的吞咽功能促进策略对头颈部癌症放疗患者的有效性:一项随机对照试验的研究方案。

Effectiveness of an evidence-based swallowing facilitation strategy for patients undergoing radiotherapy for head and neck cancer: a study protocol for a randomised controlled trial.

机构信息

Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China.

Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.

出版信息

BMJ Open. 2024 Jan 9;14(1):e072859. doi: 10.1136/bmjopen-2023-072859.

Abstract

INTRODUCTION

Dysphagia emerges as a frequent, persistent and enduring aftermath in individuals undergoing radiotherapy for head and neck cancer (HNC). Timely intervention becomes imperative to ameliorate prolonged dysphagia and curtail related complications. Among the evidence-grounded tactics, preventive swallowing training and proficient feeding management stand out as pivotal measures for precluding and mitigating dysphagia. However, past inquiries that amalgamated these dual interventions exhibited heterogeneous quality due to their restricted participant cohorts and a dearth of uniform, systematic and practicable procedural benchmarks.

METHOD/DESIGN: This randomised, parallel-controlled study enrols 94 patients diagnosed with HNC, who are undergoing radiotherapy either with or without concurrent chemotherapy. The patients will be randomly assigned to either the intervention group, which will receive a facilitation strategy to enhance swallowing function in conjunction with standard care, or the control group, which will receive typical radiotherapy care. Patient assessments will be conducted at three distinct time points: at the onset of radiotherapy (baseline), at the conclusion of radiotherapy and 3 months postradiotherapy. The primary outcome will revolve around measuring swallowing function, while secondary outcomes will encompass swallowing-related quality of life and nutritional status.

ETHICS AND DISSEMINATION

This research initiative received endorsement from the Shanghai Proton Heavy Ion Hospital Ethics Committee on 2 December 2 (Approval Number 2210-59-01). Throughout the recruitment process, patients will be acquainted with the primary aims and scope of the study. Their participation will be a voluntary choice, demonstrated by their informed consent form signatures. The outcomes of this study will be disseminated through publication in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER

Clinical Trials.gov, ChiCTR2300067550, registered 11 January 2023.

摘要

简介

头颈部癌症(HNC)患者在接受放射治疗后,常会出现持续性和长期性的吞咽困难。为了改善长期吞咽困难并减少相关并发症,及时干预至关重要。在循证策略中,预防性吞咽训练和熟练的喂养管理是预防和减轻吞咽困难的关键措施。然而,过去的研究综合了这两种干预措施,但由于其研究对象队列有限,且缺乏统一、系统和实用的程序基准,因此研究质量存在差异。

方法/设计:这是一项随机、平行对照研究,共纳入 94 例接受放疗(或联合同期化疗)的 HNC 患者。患者将被随机分为干预组和对照组。干预组在标准治疗的基础上接受增强吞咽功能的促进策略,对照组接受常规放疗。患者将在三个不同时间点进行评估:放疗开始时(基线)、放疗结束时和放疗后 3 个月。主要结局为吞咽功能,次要结局包括吞咽相关生活质量和营养状况。

伦理与传播

本研究于 2023 年 1 月 11 日获得上海质子重离子医院伦理委员会的批准(编号:2210-59-01)。在招募过程中,患者将了解研究的主要目的和范围。他们的参与是自愿的,通过签署知情同意书来体现。本研究的结果将通过发表在同行评议的期刊上进行传播。

试验注册号

ClinicalTrials.gov,ChiCTR2300067550,于 2023 年 1 月 11 日注册。

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