Exploratory Research: Patient-Reported Factors Contributing to Decreased Oral Intake During Radiotherapy in Head and Neck Cancer

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-01-24 DOI:10.1002/hed.28089

Alice Vergauwen, Margot Baudelet, Leen Van den Steen, Ann Goeleven, Sandra Nuyts, Daan Nevens, Hanne Massonet, Fréderic Duprez, Gwen Van Nuffelen

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Abstract

Background

Radiotherapy (RT) in head and neck cancer (HNC) can cause multiple side effects such as nausea, pain, taste loss, fatigue, oral mucositis, xerostomia, and acute radiation-associated dysphagia (RAD). These factors threaten patients' oral intake (OI) during this RT. Reduced OI can cause weight loss, dehydration, malnutrition, and various comorbidities. On top, reduced OI significantly affects quality of life and may contribute to RAD through the disuse of swallowing muscles. With the aim of maximizing the retention of a patient's OI, it is important to gain an insight into the factors that have the greatest impact. Therefore, this study aims to identify the impact of contributing factors on decreased OI during RT.

Methods

During their treatment, 55 HNC patients completed an OI questionnaire at 5 different time points: during weeks 1, 2, 3, and 4 and at the end of RT (week 7). First, patients rated the OI compared to pre-RT on a 100 mm visual analogue scale (VAS). Subsequently, patients reported on separate VAS the degree to which pain, fatigue, loss of taste, loss of smell, loss of interest in food, nausea, and loss of hunger contributed to the decrease in OI (0: no contribution; 100: complete contribution). SPSS version 27 was used to analyze the results.

Results

OI decreased over time during RT, with the lowest OI at the end of RT. During the first 4 weeks of RT, the impact of all factors with pain, loss of taste, loss of interest in food, and loss of hunger pointed out as strongest contributing factors to a decreased OI. The most important patient-reported impacting factor on OI was loss of taste. At the end of RT, the importance of pain and nausea still increases, while the contribution of the other factors drops slightly.

Conclusion

This cohort study shows that several factors contribute to a decreased OI in HNC patients during RT. This study is the first prospective analysis to identify self-reported factors contributing to reduced OI. Results demonstrate that taste has the greatest impact on OI followed by loss of interest in food, loss of hunger, and pain.

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探索性研究：患者报告的影响头颈癌放疗期间口服摄入量减少的因素。

背景：头颈癌（HNC）放疗（RT）可引起恶心、疼痛、味觉丧失、疲劳、口腔黏膜炎、口干和急性辐射相关吞咽困难（RAD）等多种副作用。这些因素在此过程中威胁到患者的口服摄入（OI）。降低的OI可导致体重减轻、脱水、营养不良和各种合并症。综上所述，成骨不全的减少显著影响生活质量，并可能通过吞咽肌肉的废用而导致RAD。为了最大限度地保留患者的成骨不全，了解影响最大的因素是很重要的。因此，本研究旨在确定影响因素在放疗期间降低成骨不全的影响。方法：在治疗期间，55名HNC患者在5个不同的时间点完成了一份成骨不全问卷：在第1、2、3和4周以及在放疗结束时（第7周）。首先，患者用100毫米视觉模拟量表（VAS）对与放疗前相比的成骨不全进行了评分。随后，患者在单独的VAS中报告疼痛、疲劳、味觉丧失、嗅觉丧失、对食物丧失兴趣、恶心和饥饿感丧失对OI降低的影响程度(0：无贡献；100：全额出资)。采用SPSS第27版对结果进行分析。结果：在放疗期间，成骨不全随着时间的推移而下降，在放疗结束时成骨不全最低。在放疗的前4周，疼痛、味觉丧失、对食物失去兴趣和饥饿感等所有因素的影响都被指出是导致成骨不全降低的最重要因素。患者报告的影响成骨不全最重要的因素是味觉丧失。在RT结束时，疼痛和恶心的重要性仍然增加，而其他因素的贡献略有下降。结论：该队列研究表明，在rt期间，HNC患者的成骨不全发生率降低有几个因素。该研究是首次对自我报告的成骨不全发生率降低因素进行前瞻性分析。结果表明，味觉对成骨不全的影响最大，其次是对食物失去兴趣、失去饥饿感和疼痛感。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.