Symptom Experiences and Management of Patients with Head and Neck Cancer Receiving Radiation Therapy: Integrated Review

Abstract

Symptom Experiences and Management of Patients with Head and Neck Cancer Receiving Radiation Therapy: Integrated Review H ead and neck cancer is the 6 th most prevalent type of cancer with an annual incident rate of around 600,000 new cases worldwide. 1 Head and neck cancer (HNC) includes oral, laryngeal, oropharyngeal, salivary gland and other pharynx cancers. 1 Standard treatment of head and neck cancer involves radiation therapy at any time point of the treatment trajectory either for palliative or curative purposes. 2 To date, a multidisciplinary approach uses a combination of surgery, radiotherapy, and chemotherapy in order to treat HNC. The frequencies and severity of treatment-related symptoms occur depending on the dose of radiation but worsen when combined with the side effects of chemotherapy. 3-5 A review of studies relating to radiation therapy suggested that altered fractionation radiotherapy was associated with an improvement in overall survival rates in patients with oral and oropharyngeal cancers (Hazard Ratio (HR) of mortality = 0.86, 95% CI = 0.76 to 0.98). 6 A review of chemotherapy treatment suggested that chemotherapy, in addition to radiotherapy and surgery, was associated with improved overall survival in patients with oral cavity and oropharyngeal cancers (HR of mortality = 0.84; 95% CI = 0.72 to 0.98, p = 0.03). 7 However, neither review could find sufficient evidence as to which regimen was associated with better overall survival rates.

The Lived Experiences of Patients with Head and Neck Cancer during Concurrent Chemoradiation Therapy Care Process

“…Preparing the patients with head and neck cancer for what to expect over the course of treatment has to be individually tailored in accordance with each individual's personal learning styles and preferences. In a previous study, the tailored information with effective communication could support the nursing care towards the relief of treatment-related symptoms and some distress in patients with head and neck cancer (Rojthamarat, 2018).…”

“…Currently, multiple symptom management and involvement of patients in the identification of symptom clusters are beneficial across symptoms to improve clinical outcomes (Kwekkeboom, 2016). Information and education from healthcare providers as a guidance of symptom management is necessary, but at the same time patients have to also adjust their daily life routine (Rojthamarat, 2018). Therefore, the understanding of symptom cluster burdens in patients with head and neck cancer at the time of treatment initiation is crucial in the radiation therapy care process.…”