SYMPTOM EXPERIENCES IN HEAD AND NECK CANCER SURVIVORS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Yuwen Ji; Seyedehtanaz Saeidzadeh; Stephanie Gilbertson-White

Purpose: This systematic review and meta-analysis aims to synthesize the literature describing the impact of oral symptoms and dysphagia among head and neck cancer (HNC) survivors receiving curative treatment. Oral symptoms include dry mouth, taste impairment, trismus, and mouth/throat soreness. The purpose of this analysis is to describe prevalence and severity of oral symptoms and dysphagia, and 2) evaluate the impact of oral symptoms and dysphagia on patient reported outcomes (i.e., quality-of-life, oral functioning) in HNC survivors. Significance: The population HNC survivors' is growing due to novel treatments, improvements in cancer detection, and a shift toward HNC sub-types with better prognosis (e.g. Human Papilloma Virus). HNC treatments are typically intensive and multi-modal, resulting in many survivors experiencing severe and debilitating side-effects. Some treatment-related side-effects persist well past completion of primary treatment. Oral symptoms and dysphagia are among the most significant side-effects to their impact oral intake often leading to weight-loss. These functional and physical changes can negatively impact body image and lead to social isolation. It is crucial to understand these symptoms so we can better support the survivors. Methods: The Cochrane guidelines for systematic review and meta-analysis were followed. Five major databases (i.e., PubMed, Embase, CINAHL, PsycInfo, and Scopus) were searched for studies published through 2024. Studies were included that focused on adult HNC survivors who received curative intent treatments (undergoing/completed) and experienced oral symptoms and dysphagia. Quantitative studies including cross-sectional, cohort, and interventional designs were eligible for inclusion. Mixed methods, qualitative, and reviews were excluded. Findings and Interpretations: Across six included studies, the majority of the sample was male (80.0%), non-Hispanic White (85.8%), with oropharynx tumors (47.0%) as the primary site, and diagnosed at Stage II (30.7%). The mean age of participants was 60.05 years (SD = 10.2). Participants (n=999, 92.9%) completed treatment an average of 9.8 years ago. Studies revealed that participants with moderate or severe dysphagia experienced significantly reduced quality-of-life. The most substantial impacts reported were on swallowing, speech, and eating. Participants with hypopharyngeal cancers and those treated with surgery plus radiation/ chemoradiation experienced the worst symptom severity and highest interference with daily life. Discussion: Further research is required, particularly among more diverse populations, such as women and nonwhite HNC survivors. In addition, the development and testing of self-management interventions is needed to reduce the devasting impact of HNC treatment side-effects.

SYMPTOM EXPERIENCES IN HEAD AND NECK CANCER SURVIVORS: A SYSTEMATIC REVIEW AND META-ANALYSIS

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