Symptom Profile of Nasopharyngeal Cancer Patients during Radiation Therapy

Hsiu-Ying Huang ph d, rn, aocn, Diana J. Wilkie ph d, rn, aocn, faan, Mark M. Schubert dds, msd , Lai-Lei Ting md
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Abstract

Purpose: This prospective, longitudinal study was aimed to describe the prevalence, severity, and pattern of symptoms over the course of radiation therapy in persons with nasopharyngeal carcinoma and to explore symptom severity by treatment modality.

description of Study: Thirty-seven patients completed this study, and 46% received chemotherapy before radiation therapy. A self-reported radiation symptom checklist and an objective mucositis assessment tool were used weekly to document oropharyngeal, skin, nose or ear, or more general side effects, and mucositis.

Results: Oropharyngeal problems were the most severe complaints during radiation therapy. All patients experienced dry mouth, taste change, difficulty in swallowing, difficulty in opening their mouths, hoarseness, sore throat, and observable mucositis. Most reported moderate-to-severe dry mouth, difficulty in swallowing, and sore throat from weeks 3 through 7. Skin problems were not prominent until week 4. Patients also lost an average of 3.9 kg during the therapy. Sequential chemotherapy and radiation therapy was associated with more severe oropharyngeal problems than radiation therapy alone, but no significant differences in other problems were found.

clinical Implications: Despite recognition of the oropharyngeal side effects associated with irradiation, effective management protocols for such symptoms have not been implemented in the studied institution. The frequency and intensity of the symptoms reported indicate an urgent need for increased vigilance about radiation-related side effects and pain management. As well, patient education about expected side effects may help mitigate the anxiety that patients experience when these symptoms occur.

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鼻咽癌放射治疗患者的症状分析
目的:这项前瞻性、纵向研究旨在描述鼻咽癌患者放射治疗过程中症状的患病率、严重程度和模式,并通过治疗方式探讨症状严重程度。研究描述:37名患者完成了这项研究,46%的患者在放射治疗前接受了化疗。每周使用自我报告的放射症状检查表和客观的粘膜炎评估工具来记录口咽、皮肤、鼻子或耳朵或更一般的副作用和粘膜炎。结果:口咽问题是放射治疗中最严重的主诉。所有患者均出现口干、味觉改变、吞咽困难、开口困难、声音嘶哑、喉咙痛和明显的粘膜炎。大多数报告在第3至7周出现中度至重度口干、吞咽困难和喉咙痛。直到第4周皮肤问题才明显。在治疗期间,患者的体重平均减少了3.9公斤。序贯化疗和放疗比单独放疗与更严重的口咽问题相关,但在其他问题上没有发现显著差异。临床意义:尽管认识到与辐照相关的口咽副作用,但在研究机构中尚未实施有效的此类症状管理方案。所报告的症状的频率和强度表明,迫切需要提高对辐射相关副作用和疼痛管理的警惕。此外,对患者进行有关预期副作用的教育可能有助于减轻患者在出现这些症状时所经历的焦虑。
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