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

Barnhart, Molly K., Robinson, Rachelle A., Simms, Virginia A., Ward, Elizabeth C., Cartmill, Bena, Chandler, Sophie J. and Smee, Robert I. (2018) Treatment toxicities and their impact on oral intake following non-surgical management for head and neck cancer: a 3-year longitudinal study. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, . doi:10.1007/s00520-018-4076-6


Author Barnhart, Molly K.
Robinson, Rachelle A.
Simms, Virginia A.
Ward, Elizabeth C.
Cartmill, Bena
Chandler, Sophie J.
Smee, Robert I.
Title Treatment toxicities and their impact on oral intake following non-surgical management for head and neck cancer: a 3-year longitudinal study
Journal name Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer   Check publisher's open access policy
ISSN 1433-7339
0941-4355
Publication date 2018-02-07
Year available 2018
Sub-type Article (original research)
DOI 10.1007/s00520-018-4076-6
Open Access Status Not yet assessed
Total pages 11
Place of publication Heidelberg, Germany
Publisher Springer
Abstract 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.

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.

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.

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.
Keyword Barriers
Dysphagia
Head and neck cancer
Oral intake
Toxicities
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Health and Rehabilitation Sciences Publications
 
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Created: Wed, 14 Feb 2018, 11:06:13 EST