胸部肿瘤患者放射性食管炎预防及管理的最佳证据总结

Summary of best evidence for prevention and management of radiation esophagitis in patients with chest tumors

目的总结胸部肿瘤患者放射性食管炎预防及管理的最佳证据,为临床患者预防及管理放射性食管炎提供相关依据。方法按照PIPOST模型提出研究问题,依据"6S"模型系统检索UpToDate、BMJ最佳实践、Cochrane Library、PubMed、美国临床肿瘤学会、中国知网、万方数据库等数据库和网站中与胸部肿瘤患者放射性食管炎预防及管理相关的指南、专家共识、临床决策、证据总结、系统评价、随机对照试验。检索时限均为建库至2023年8月1日。由2名研究员对文献的质量进行独立评价,对符合质量标准的文献进行证据提取和整合。结果共计纳入10篇文献,包含指南3篇、专家共识1篇、系统综述1篇、系统评价2篇、随机对照试验3篇;归纳为搭建多学科团队、筛查评估、营养支持、药物与非药物预防、中西医结合治疗及健康宣教6个维度23条证据。结论本研究所纳入的相关证据可为胸部肿瘤放疗患者放射性食管炎的预防及管理提供理论依据,临床医务人员可结合临床实际给予患者个体化干预。

Objective To summarize the best evidence for the prevention and management of radiation esophagitis in patients with chest tumors,so as to provide basis for the prevention and management of radiation esophagitis in patients.Methods The research question was proposed based on the population,intervention,professional,outcome,setting and type of evidence(PIPOST)model,and guidelines,expert consensus,clinical decision-making,evidence summary,systematic review,and randomized controlled trials on the prevention and management of radiation esophagitis in chest tumor patients were systematically searched on UpToDate,BMJ Best Practice,Cochrane Library,PubMed,American Society of Clinical Oncology,China National Knowledge Infrastructure,WanFang Data,and other databases and websites based on the"6S"model.The search period was from database establishment to August 1,2023.Two researchers independently evaluated the quality of the literature and extracted and integrated evidence from the literature that met the quality standards.Results A total of ten articles were included,including three guidelines,one expert consensus,one systematic review,two systematic evaluations,and three randomized controlled trials.Twenty-three pieces of evidence were summarized from six dimensions of building multidisciplinary teams,screening and evaluation,nutritional support,drug and non-drug prevention,integrated traditional Chinese and western medicine treatment,and health education.Conclusions The included evidence can provide a theoretical basis for the prevention and management of radiation esophagitis in patients undergoing chest tumor radiotherapy.Clinical medical and nursing personnel can provide personalized interventions to patients based on clinical practice.