无病口咽癌幸存者放化疗后患者报告的吞咽负担与FEES检查结果
Patient-reported swallowing burden and FEES findings in disease-free oropharyngeal cancer survivors after chemoradiotherapy.
文献信息
| PMID | 42842011 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Daniela Oliveira Vieira |
| 作者单位 | Rede de Investigação Em Saúde (RISE-Health), Instituto de Investigação, Inovação e Desenvolvimento (FP-I3ID), Biomedical and Health Sciences Research Unit (FP-BHS), Porto, Portugal. dvieira@ufp.edu.pt. |
| 期刊 | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer |
| SCI 分区 | Q1 |
| IF | 3.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 口咽吞咽困难是接受放化疗（CRT）治疗的口咽癌幸存者中常见的长期后遗症，对生活质量（QoL）有显著影响。柔性内镜吞咽评估（FEES）可提供吞咽生理学的客观信息，而患者报告结局指标（PROMs）则反映患者感知的吞咽困难负担。本研究探讨了FEES检查结果与PROMs如何为接受CRT治疗的无病幸存者的吞咽困难提供互补信息。
方法： 对38例接受CRT治疗的无病口咽癌幸存者进行了一项横断面研究。使用FEES评估吞咽功能，包括吞咽安全性、效率和时间生理学指标。使用EORTC QLQ-C30、EORTC QLQ-H&N43和SWAL-QOL问卷评估吞咽相关生活质量和症状负担。采用相关性和比较分析探讨客观与主观结局之间的关联。
结果： FEES发现频繁的吞咽障碍，尤其是咽部残留、固体食物需要增加吞咽次数以及渗透-误吸事件。PROMs也显示存在显著的吞咽困难相关负担，其中SWAL-QOL识别出的异常结果比例最高。观察到FEES检查结果与生活质量领域之间存在关联；然而，未发现生理性损害与患者报告负担之间存在一致的一一对应关系。
结论： FEES和PROMs捕捉了CRT后无病口咽癌幸存者吞咽困难的不同互补维度。FEES识别生理性吞咽损害，而PROMs反映吞咽困难的功能和社会心理影响。联合使用仪器评估和患者报告评估可能改善该人群的支持性护理和长期随访。
英文摘要
PURPOSE: Oropharyngeal dysphagia is a frequent long-term sequela in survivors of oropharyngeal cancer treated with chemoradiotherapy (CRT), with significant impact on quality of life (QoL). Flexible endoscopic evaluation of swallowing (FEES) provides objective information on swallowing physiology, whereas patient-reported outcome measures (PROMs) capture perceived dysphagia burden. This study explored how FEES findings and PROMs provide complementary information regarding dysphagia in disease-free survivors treated with CRT.
METHODS: A cross-sectional study was conducted in 38 disease-free survivors of oropharyngeal cancer treated with CRT. Swallowing was assessed using FEES, including measures of swallowing safety, efficiency and temporal physiology. Swallowing-related QoL and symptom burden were assessed using the EORTC QLQ-C30, EORTC QLQ-H&N43, and SWAL-QOL questionnaires. Associations between objective and subjective outcomes were explored using correlation and comparative analyses.
RESULTS: FEES identified frequent swallowing impairments, particularly pharyngeal residue, increased number of swallows for solid consistencies and penetration-aspiration events. PROMs also revealed substantial dysphagia-related burden, with the SWAL-QOL identifying the highest proportion of altered results. Associations between FEES findings and QoL domains were observed; however, no consistent one-to-one relationship between physiological impairment and patient-reported burden was identified.
CONCLUSION: FEES and PROMs capture complementary dimensions of dysphagia in disease-free survivors of oropharyngeal cancer after CRT. FEES identifies physiological swallowing impairments, whereas PROMs reflect the functional and psychosocial impact of dysphagia. Combined use of instrumental and patient-reported assessments may improve supportive care and long-term follow-up in this population.