新诊断头颈癌患者口咽吞咽困难的患病率及危险因素

Prevalence and Risk Factors of Oropharyngeal Dysphagia in Newly Diagnosed Head-and-Neck Cancer Patients.

作者信息

Florie Michelle G M H, Wieland Monse W M, Pilz Walmari, Partoens Rosanne, Winkens Bjorn, Hoeben Ann, Rommel Nathalie, Baijens Laura W J

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.

GROW-Research Institute for Oncology and Reproduction, Maastricht University, P.O. Box 6200, 6211 LK Maastricht, The Netherlands.

出版信息

Cancers (Basel). 2024 Dec 24;17(1):9. doi: 10.3390/cancers17010009.

Abstract

BACKGROUND

Head-and-neck cancer (HNC) can cause oropharyngeal dysphagia (OD). Early identification of OD in newly diagnosed HNC patients is important to better prepare patients for their cancer treatment trajectory. The aim of this study is (1) to assess the prevalence of OD in HNC patients within three weeks before the start of cancer treatment and (2) to investigate which demographic and oncological characteristics may be risk factors associated with the risk of OD at baseline.

METHODS

Patients (N = 225) completed the Eating Assessment Tool-10 (EAT-10) and Short Nutritional Assessment Questionnaire (SNAQ). Logistic regression analysis was conducted to examine the association between OD versus demographic and oncological characteristics.

RESULTS

A total of 21.3% (proportion 0.213; 95% CI 0.163-0.274) of the patients were at risk for OD. After correction for age, Charlson Comorbidity Index (CCI) grade, and primary tumor location, a significant association was found between advanced-stage cancer versus the risk of OD. Additionally, post hoc analysis revealed a significant association between the risk of malnutrition versus the risk of OD.

CONCLUSIONS

Approximately one-fifth of all newly diagnosed HNC patients are at risk of OD, with advanced-stage cancer and malnutrition emerging as significant risk factors of OD. These findings empower health professionals toward more effective screening and management of a patient's risk profile before the start of HNC treatment.

摘要

背景

头颈癌(HNC)可导致口咽吞咽困难(OD)。在新诊断的HNC患者中早期识别OD对于更好地让患者为其癌症治疗过程做好准备很重要。本研究的目的是:(1)评估在癌症治疗开始前三周内HNC患者中OD的患病率;(2)调查哪些人口统计学和肿瘤学特征可能是与基线时OD风险相关的危险因素。

方法

患者(N = 225)完成了饮食评估工具-10(EAT-10)和简短营养评估问卷(SNAQ)。进行逻辑回归分析以检验OD与人口统计学和肿瘤学特征之间的关联。

结果

共有21.3%(比例0.213;95%置信区间0.163 - 0.274)的患者有OD风险。在校正年龄、查尔森合并症指数(CCI)分级和原发肿瘤部位后,发现晚期癌症与OD风险之间存在显著关联。此外,事后分析显示营养不良风险与OD风险之间存在显著关联。

结论

所有新诊断的HNC患者中约五分之一有OD风险,晚期癌症和营养不良是OD的重要危险因素。这些发现使卫生专业人员能够在HNC治疗开始前更有效地筛查和管理患者的风险状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c701/11718782/e3a76bae68b7/cancers-17-00009-g001.jpg

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