放射性吞咽困难的研究进展

Research progress in radiation-induced dysphagia

吞咽困难是头颈部肿瘤放化疗的主要并发症。近年来,随着多学科联合治疗的推进,头颈部肿瘤获得了更高的肿瘤控制率,但同时带来了更高的晚期放射性吞咽困难发生率。放射性吞咽困难可以导致患者长期无法自然进食、营养缺乏、体重减轻,甚至还有误吸和吸入性肺炎的风险,极大地降低了患者的生活质量,而晚期放射性吞咽困难也成为限制增大治疗强度的主要原因。因此,深入了解头颈部肿瘤放射性吞咽困难发生发展的机制,积极探寻有效的防治措施,对于提高头颈部肿瘤患者的生存率及生活质量有着重要意义。本文总结了头颈部肿瘤放射性吞咽困难的发生机制、发生情况和危险因素,以及在测量报告方法和防治措施等方面的进展。

Dysphagia is the main complication of chemoradiotherapy for head and neck cancer.Recently,the advancement of multidisciplinary treatment has achieved a higher tumor control rate,but also a higher incidence of late radiation-induced dysphagia in head and neck cancer.Radiation-induced dysphagia leads to prolonged unnatural feeding,nutritional deficiency,weight loss,and also has a major risk for silent aspiration and aspiration pneumonia,which significantly reduces the quality of life of patients.Besides,late radiation-induced dysphagia is the main reason for limiting the intensity of treatment.Therefore,it is of great significance to deeply understand the pathogenesis of radiation-induced dysphagia and actively explore effective prevention and treatment measures to improve the survival rate and quality of life in head and neck cancer.This paper summarizes the pathogenesis,occurrence,risk factors of radiation-induced dysphagia in head and neck cancer,as well as the progress in the measurement and reporting methods,prevention and treatment strategies.