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01-07-2018 | Original Article

Treatment toxicities and their impact on oral intake following non-surgical management for head and neck cancer: a 3-year longitudinal study

Authors: Molly K. Barnhart, Rachelle A. Robinson, Virginia A. Simms, Elizabeth C. Ward, Bena Cartmill, Sophie J. Chandler, Robert I. Smee

Published in: Supportive Care in Cancer | Issue 7/2018

Abstract

Purpose

Patients who receive (chemo)radiotherapy [(C)RT] for head and neck cancer (HNC) experience multiple treatment effects. However, the presence and recovery of treatment toxicities and how these impact on oral intake over time post-treatment are not fully understood. The primary aim of this study was to examine patient perceptions of the toxicities present and which are barriers to oral intake, up to 3 years post (C)RT. The secondary aim was to identify mealtime strategies used to optimise oral intake.

Methods

A prospective cohort of 96 patients after completion of (C)RT for HNC reported the presence of toxicities, if they were barriers to oral intake, and use of any mealtime strategies at the end of treatment (EoT), and at 3, 6, 12, 24, and 36 months post-treatment.

Results

All toxicities and reported barriers changed over time (p < 0.05) except trismus. Odynophagia, reduced appetite, and fatigue improved (p < 0.05) by 3 months. Significantly less patients reported xerostomia and dysgeusia as barriers to oral intake at 3 months despite no improvement in their presence. No change in the presence of any toxicity or its impact on oral intake occurred from 12 to 36 months, with exception of dentition problems which significantly increased at 36 months. Alternating food/fluids was the most frequently used mealtime swallowing strategy at all time points beyond the EoT.

Conclusions

The dysphagia and associated toxicities HNC patients experience are chronic in nature. Rehabilitation should include mealtime strategies and support with adjusting to the changing presence and impact of toxicities on oral intake.

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Title: Treatment toxicities and their impact on oral intake following non-surgical management for head and neck cancer: a 3-year longitudinal study
Authors: Molly K. Barnhart
Rachelle A. Robinson
Virginia A. Simms
Elizabeth C. Ward
Bena Cartmill
Sophie J. Chandler
Robert I. Smee
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 7/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4076-6

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