The natural history of weight and swallowing outcomes in oropharyngeal cancer patients following radiation or concurrent chemoradiation therapy

Jovanovic, Nedeljko; Dreyer, Colleen; Hawkins, Sarah; Thouless, Kendra; Palma, David A.; Doyle, Philip C.; Theurer, Julie

doi:10.1007/s00520-020-05628-1

Cited by 12 publications

(7 citation statements)

References 49 publications

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“…Actually, at a post hoc analysis a completely opposite trend was observed for all MDADI scores for patients with normal ability (“optimal”) compared with those with a certain degree of disability (“adequate” and “poor”) at baseline. Interestingly, “optimal” patients underwent a statistically significant worsening of all MDADI scores at 6 months followed by a slight non-statistically significant improvement at 12 months, according to most of the literature data on this issue [ 23 – 25 ]. On the contrary, “adequate/poor” patients experienced a statistically significant improvement of their function at 6 months followed by a subsequent stabilization at 12 months.…”

Section: Discussionmentioning

confidence: 98%

“…To date, most important experiences on this issue [ 13 , 25 , 26 ] are concordant in reporting a significant worsening of MDADI-C score early after treatment (mostly at 3 months) followed by a slow improvement at 6 and 12 months without returning to the baseline values, indicating a gradual partial recovery of deglutition-related QoL. The comparison of these data with ours might be troubled due to the opposite trend of MDADI-C scores between the two groups (“optimal” vs “adequate/poor”) that cancel the impact of treatment showing no significant differences in MDADI scores from before to after treatment.…”

Section: Discussionmentioning

confidence: 99%

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Patient-Reported Outcomes After Swallowing (SWOARs)-Sparing IMRT in Head and Neck Cancers: Primary Results from a Prospective Study Endorsed by the Head and Neck Study Group (HNSG) of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

et al. 2022

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Objectives To prospectively investigate changes in M.D. Anderson Dysphagia Inventory (MDADI) scores in patients affected by naso- and oropharynx cancer after definitive radiochemotherapy (ChemoRT) using swallowing organs at risk (SWOARs)-sparing IMRT. Methods MDADI questionnaires were collected at baseline and at 6 and 12 months after treatment. MDADI scores were categorized as follows: ≥ 80 “optimal,” 80–60 “adequate,” < 60 “poor” deglutition-related quality of life (QoL) group, and dichotomized as “optimal” vs “adequate/poor” for the analysis. A mean MDADI composite (MDADI-C) change of 10 points was considered as minimal clinically important difference (MCID). Results Sixty-three patients were enrolled of which 47 were considered for the analysis. At baseline, 26 (55%) were “optimal” and 21 (45%) were “adequate/poor.” The mean baseline MDADI-C score was 93.6 dropping to 81 at 6 months (p = 0.013) and slightly rising to 85.5 at 12 months (p = 0.321) for the “optimal” group. Indeed, the mean baseline MDADI-C score was 64.3 rising to 77.5 at 6 months (p = 0.006) and stabilizing at 76 at 12 months (p = 0.999) for the “adequate/poor” group. A statistically significant but not clinically relevant worsening of the MDADI-C score was reported for the “optimal” group, whereas both a statistically significant and clinically meaningful improvement of the MDADI-C score were reported for the “adequate/poor” group from before to post-treatment. Conclusion Our results suggest a doubly clinical benefit of dose optimization to SWOARs to minimize the RT sequalae in patients with a baseline “optimal” deglutition-related QoL and to recover from cancer dysphagia in those with a baseline “adequate/poor” deglutition-related QoL.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Patient-Reported Outcomes After Swallowing (SWOARs)-Sparing IMRT in Head and Neck Cancers: Primary Results from a Prospective Study Endorsed by the Head and Neck Study Group (HNSG) of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

et al. 2022

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“…The D‐PSS‐HN can also easily be used in research setting, for example to assess the evolution of patients’ functioning before, immediately after and months to years after a specific treatment. The English scale is already frequently used for this purpose (Barbon et al., 2022; Brady et al., 2022; Jovanovic et al., 2021). However, our study is not without limitations.…”

Section: Discussionmentioning

confidence: 99%

Supportive care among head and neck cancer patients: An initial validation of the Dutch version of the Performance Status Scale for Head and Neck Cancer (D‐PSS‐HN)

Baudelet

Steen

Wouters

et al. 2023

Intl J Lang & Comm Disor

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BackgroundAcute and late toxicities in patients treated with (chemo)radiotherapy for head and neck cancer (HNC) is common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population.AimsSince Dutch performance status scales for the HNC population are lacking, we conducted this study to translate the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and to validate this version.Methods & ProceduresThe D‐PSS‐HN was translated into Dutch according to the internationally described cross‐cultural adaptation process. It was administered to HNC patients and together with the Functional Oral Intake Scale completed by a speech and language pathologist at five different time points during the first 5 weeks of (chemo)radiotherapy. Patients were asked each time to complete the Functional Assessment of Cancer Therapy and the Swallowing Quality of Life Questionnaire. Pearson correlation coefficients were used to calculate convergent and discriminant validity and the evolution of D‐PSS‐HN scores was assessed by means of linear mixed models.Outcomes & ResultsA total of 35 patients were recruited and > 98% of the clinician‐rated scales were completed. Convergent and discriminant validity were demonstrated, with all correlations rs between 0.467 and 0.819, and between 0.132 and 0.256, respectively. The subscales of the D‐PSS‐HN are sensitive to detect changes through time.Conclusion & ImplicationsThe D‐PSS‐HN is a valid and reliable instrument to assess performance status in patients with HNC treated with (chemo)radiotherapy. It is a useful tool to measure HNC patients’ current diet level and functional abilities to perform daily life activities.WHAT THIS PAPER ADDSWhat is already known on the subject Acute and late toxicities in patients treated with (chemo)radiotherapy for HNC are common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population. However, Dutch performance status scales for the HNC population are lacking. Therefore, we translated the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and validated this version.What this paper adds to existing knowledge We translated the PSS‐HN and demonstrated its convergent and discriminant validity. The subscales of the D‐PSS‐HN are sensitive to detect changes through time.What are the potential or actual clinical implications of this work? The D‐PSS‐HN is a useful tool to measure HNC patients’ functional abilities to perform daily life activities. The tool can easily be used in clinical settings: since data collection duration is very short, this facilitates clinical (and research‐related) implementation of the scale. Patients’ individual needs could be identified by using the D‐PSS‐HN, resulting in more appropriate approaches and (early) referrals if needed. Interdisciplinary communication could be facilitated.

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“…In 2020, Jovanovic et al [ 26 ] investigated the natural history of weight and swallowing outcomes in patients with and without feeding tube (FT) insertion. The authors analyzed retrospectively 122 OPC patients undergoing CRT at a single regional cancer center between January 2013 and December 2015.…”

Section: The Optimal Timing Of Nutritional Support In Hnc Patientsmentioning

confidence: 99%

“…The authors concluded that clinically relevant loss of weight and decreased swallowing-related QoL in the first-year following treatment was noted in OPC patients regardless of FT insertion. Therefore, nutritional assessment and nutritional support are very important in OPC patients [ 26 ].…”

Section: The Optimal Timing Of Nutritional Support In Hnc Patientsmentioning

confidence: 99%

Nutritional Support in Head and Neck Radiotherapy Patients Considering HPV Status

et al. 2020

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Malnutrition is a common problem in patients with head and neck cancer (HNC), including oropharyngeal cancer (OPC). It is caused by insufficient food intake due to dysphagia, odynophagia, and a lack of appetite caused by the tumor. It is also secondary to the oncological treatment of the basic disease, such as radiotherapy (RT) and chemoradiotherapy (CRT), as a consequence of mucositis with the dry mouth, loss of taste, and dysphagia. The severe dysphagia leads to a definitive total impossibility of eating through the mouth in 20–30% of patients. These patients usually require enteral nutritional support. Feeding tubes are a commonly used nutritional intervention during radiotherapy, most frequently percutaneous gastrostomy tube. Recently, a novel HPV-related type of OPC has been described. Patients with HPV-associated OPC are different from the HPV− ones. Typical HPV− OPC is associated with smoking and alcohol abuse. Patients with HPV+ OPC are younger and healthy (without comorbidities) at diagnosis compared to HPV− ones. Patients with OPC are at high nutritional risk, and therefore, they require nutritional support in order to improve the treatment results and quality of life. Some authors noted the high incidence of critical weight loss (CWL) in patients with HPV-related OPC. Other authors have observed the increased acute toxicities during oncological treatment in HPV+ OPC patients compared to HPV− ones. The aim of this paper is to review and discuss the indications for nutritional support and the kinds of nutrition, including immunonutrition (IN), in HNC, particularly OPC patients, undergoing RT/CRT, considering HPV status.

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The natural history of weight and swallowing outcomes in oropharyngeal cancer patients following radiation or concurrent chemoradiation therapy

Cited by 12 publications

References 49 publications

Patient-Reported Outcomes After Swallowing (SWOARs)-Sparing IMRT in Head and Neck Cancers: Primary Results from a Prospective Study Endorsed by the Head and Neck Study Group (HNSG) of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Patient-Reported Outcomes After Swallowing (SWOARs)-Sparing IMRT in Head and Neck Cancers: Primary Results from a Prospective Study Endorsed by the Head and Neck Study Group (HNSG) of the Italian Association of Radiotherapy and Clinical Oncology (AIRO)

Supportive care among head and neck cancer patients: An initial validation of the Dutch version of the Performance Status Scale for Head and Neck Cancer (D‐PSS‐HN)

Nutritional Support in Head and Neck Radiotherapy Patients Considering HPV Status

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