High symptom burden prior to radiation therapy for head and neck cancer: A patient-reported outcomes study

• Published in: Head & neck Vol. 35; no. 10; pp. 1490 - 1498
• Main Authors: Gunn, G. Brandon, Mendoza, Tito R., Fuller, Clifton D., Gning, Ibrahima, Frank, Steven J., Beadle, Beth M., Hanna, Ehab Y., Lu, Charles, Cleeland, Charles S., Rosenthal, David I.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2013; Wiley Subscription Services, Inc
• Subjects: Adaptation, Physiological; Adaptation, Psychological; Adult; Aged; Cancer Care Facilities; Cluster Analysis; Cohort Studies; Deglutition Disorders - epidemiology; Deglutition Disorders - etiology; Fatigue - epidemiology; Fatigue - etiology; Female; head and neck cancer; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - radiotherapy; Humans; Male; MDASI-HN; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness; Neoplasm Staging; patient-reported outcomes; Prospective Studies; Quality of Life; Self Report; Sickness Impact Profile; Sleep Wake Disorders - epidemiology; Sleep Wake Disorders - etiology; Stress, Psychological; Surveys and Questionnaires; Survivors; symptom burden; symptom research; Texas; Texas; symptom burden; patient-reported outcomes; MDASI-HN; head and neck cancer; symptom research
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.23181

Background As a first step toward developing effective strategies to control symptoms associated with head and neck cancer (HNC) and its treatment, we sought to describe the pattern of symptoms experienced before radiation therapy. Methods Subjects completed the MD Anderson Symptom Inventory–Head and Neck Module before beginning radiation therapy. Results In all, 270 patients participated. Symptom severity and interference varied between treatment‐naïve patients and those with prior treatment. Cluster analyses revealed that 33% of patients had high symptom burden. Symptoms most often rated moderate‐to‐severe were fatigue, sleep disturbance, distress, pain, and problems chewing and swallowing. Poorer performance status, higher T classification, and receipt of previous treatment correlated with higher symptom burden. Conclusions A substantial proportion of patients were experiencing high symptom burden. Because few interventions currently exist for several of the most problematic symptoms, research in symptom reduction that targets the pattern of symptoms described here is greatly needed. © 2012 Wiley Periodicals, Inc. Head Neck 35: 1490–1498, 2013