Silva Danielle Nunes Moura, Jardim Yohane Cristina Guimarães, Vicente Laélia Cristina Caseiro, de Lima Friche Amélia Augusta
Department of Speech-Language Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Oncoclinicas/MedSir, Belo Horizonte, MG, Brazil.
Dysphagia. 2025 Sep 13. doi: 10.1007/s00455-025-10876-6.
In palliative care, there is still a lack of data regarding the relationship between survival, symptoms, and functionality. To investigate the relationship between functionality and both dysphagia-progression-free survival and overall survival in patients with advanced cancer. A prospective cohort conducted between March 2022 and August 2023. The study was conducted with patients with advanced cancer outside the head and neck and upper gastrointestinal tract, followed by an outpatient palliative care team. Sociodemographic, psychosocial, clinical, functional, and nutritional data were analyzed. A speech therapy evaluation was performed to classify swallowing disorders and the feeding route associated with swallowing ability. Two cohorts were analyzed according to functionality. 39 individuals were eligible, the majority being female. Lower functionality was a significant risk factor for mortality (p < 0.05), with a 4.31-fold increased risk of death. Minimal swallowing declines were associated with worse survival in patients with poorer functionality in univariable analysis (p = 0.01), but this association was not observed in multivariable analysis. Declining functionality was identified as a significant risk factor for mortality. Swallowing ability revealed a negative impact on survival in univariable analysis, however this association was not confirmed in the multivariable model. Likewise, dysphagia-progression-free survival was shorter among patients with poorer functionality, although this was not statistically significant in multivariable analysis. These findings underscore the need for further investigation.
在姑息治疗中，关于生存、症状和功能之间的关系仍然缺乏数据。为了研究晚期癌症患者的功能与无吞咽困难进展生存期及总生存期之间的关系。于2022年3月至2023年8月进行了一项前瞻性队列研究。该研究针对的是头颈部和上消化道以外的晚期癌症患者，由门诊姑息治疗团队进行随访。分析了社会人口统计学、心理社会、临床、功能和营养数据。进行了言语治疗评估，以对吞咽障碍和与吞咽能力相关的进食途径进行分类。根据功能对两个队列进行了分析。39人符合条件，大多数为女性。功能较低是死亡的一个显著危险因素（p < 0.05），死亡风险增加4.31倍。在单变量分析中，吞咽功能的最小下降与功能较差患者的较差生存期相关（p = 0.01），但在多变量分析中未观察到这种关联。功能下降被确定为死亡的一个显著危险因素。在单变量分析中，吞咽能力对生存有负面影响，然而在多变量模型中这种关联未得到证实。同样，功能较差的患者无吞咽困难进展生存期较短，尽管在多变量分析中这没有统计学意义。这些发现强调了进一步研究的必要性。
