Assessing patient-reported symptom burden of long-term head and neck cancer survivors at annual surveillance in survivorship clinic

Thomas G Townes; Sriram Navuluri; Kristen B Pytynia; Gary Brandon Gunn; Mona J Kamal; Katherine R Gilmore; Patricia H Chapman; Katherine V Bell; Danielle M Fournier; Monica A Janik; Liza M Joseph; Sara Zendehdel; Katherine A Hutcheson; Ryan P Goepfert

doi:10.1002/hed.26119

Assessing patient-reported symptom burden of long-term head and neck cancer survivors at annual surveillance in survivorship clinic

Head Neck. 2020 Aug;42(8):1919-1927. doi: 10.1002/hed.26119. Epub 2020 Feb 29.

Authors

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.
² Department of Otolaryngology, Head and Neck Surgery, University of Arkansas, Little Rock, Arkansas.
³ Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
⁴ Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
⁵ Department of Symptom Research, University of Texas MD Anderson Cancer Center, Houston, Texas.
⁶ Department of Clinical Oncology and Nuclear Medicine, Ain Shams University, Cairo, Egypt.
⁷ Division of Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas.
⁸ Department of Cancer Survivorship, University of Texas MD Anderson Cancer Center, Houston, Texas.

PMID: 32112621
DOI: 10.1002/hed.26119

Abstract

Background: This study reports long-term head and neck cancer (HNC) patient-reported symptoms using the MD Anderson Symptom Inventory Head and Neck Cancer Module (MDASI-HN) in a large cohort of HNC survivors.

Methods: MDASI-HN results were prospectively collected from an institutional survivorship database. Associations with clinicopathologic data were analyzed using χ² , Mann-Whitney, and univariate regression.

Results: Nine hundred and twenty-eight patients were included. Forty-six percent had oropharyngeal primary tumors. Eighty-two percent had squamous cell carcinoma. Fifty-six percent of patients had ablative surgery and 81% had radiation therapy as a component of treatment. The most severe symptoms were xerostomia and dysphagia. Symptom scores were worst for hypopharynx and varied by subsite. Patients treated with chemoradiation or surgery followed by radiation ± chemotherapy reported the worst symptoms while patient treated with surgery plus radiation ± chemotherapy reported the worst interference.

Conclusion: HNC survivors describe their long-term symptom burden and inform efforts to improve care many years into survivorship.

MeSH terms

Cancer Survivors*
Head and Neck Neoplasms* / therapy
Humans
Patient Reported Outcome Measures
Quality of Life
Survivors
Survivorship