Symptom burden in head and neck cancer: impact upon oral energy and protein intake |
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Authors: | Heidi Ganzer Riva Touger-Decker James S Parrott Barbara A Murphy Joel B Epstein Maureen B Huhmann |
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Institution: | 1. Minnesota Oncology Hematology PA, 675 East Nicollet Boulevard, Suite 200, Burnsville, MN, 55337, USA 2. Department of Nutritional Sciences, School of Health Related Professions, Division of Nutrition, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA 3. Vanderbilt-Ingram Cancer Center, Nashville, TN, USA 4. Division of Otolaryngology, Head and Neck Surgery City of Hope, Duarte, California and Medical Staff, Cedar-Sinai Medical Center, Los Angeles, CA, USA
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Abstract: | Purpose This study explored relationships between oral symptom burden (xerostomia, thick secretions, and mucosal sensitivity), energy and protein intake, and weight change over time among head and neck cancer (HNC) patients who have completed concurrent chemoradiation (CCR). Methods Symptom burden was assessed utilizing the Vanderbilt Head and Neck Symptom Survey version 2.0. Weight change was measured from diagnosis to treatment completion, and to the early, mid, and late recovery stage. Energy and protein intake were determined utilizing 24-h diet recalls. Results Forty-three adult patients treated for HNC enrolled in the study. Mean percentage weight loss from diagnosis to treatment completion was 7.91?±?4.06 %. Within the mid-recovery stage significant inverse relationships were found between oral protein intake and xerostomia and mucosal sensitivity (r?=??0.818, p?=?0.012; r?=??0.726, p?=?0.032, respectively). After controlling for weight change, significant inverse relationships were found within the mid-recovery stage between oral energy intake and xerostomia and mucosal sensitivity (r?=??0.740, p?=?0.046; r?=??0.751, p?=?0.043, respectively). Significant, inverse relationships were also found between oral protein intake and xerostomia and mucosal sensitivity (r?=??0.835, p?=?0.019; r?=??0.726, p?=?0.033, respectively). Conclusions Xerostomia and mucosal sensitivity were significantly related to oral energy and protein intake post-CCR in mid-recovery. Weight loss was greatest from diagnosis to treatment completion and continued through the mid-recovery stage. Assessment of oral symptom burden (xerostomia and mucosal sensitivity) and its impact on oral intake and weight post-CCR should be conducted routinely in good patient care. |
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