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Patient-reported outcome measures in patients undergoing radiotherapy for head and neck cancer

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Abstract

Objectives

Head and neck (H&N) cancer patients experience significant acute side effects from treatment. This study evaluates prospectively collected patient-reported outcomes (PROs) in H&N patients undergoing radiotherapy (RT) to assess feasibility of electronically collecting PROs and to objectively document symptom acuity and trajectory during RT.

Materials and methods

H&N patients undergoing radical RT at our multicentre institution completed a 12-item partial survey of the Vanderbilt Head & Neck Symptom Survey 2.0 prior to RT and weekly on RT. Between October 2016 and October 2018, 318 of 333 patients completed a baseline survey and at least one weekly survey.

Results

The average number of weekly questionnaires completed was 5 (range 1–8). The mean maximum symptom scores were highest for dysgeusia (5.8/10), pain (5.4/10), mucositis (4.8/10), weight loss due to swallowing (4.5/10) and mucus causing choking/gagging (4.3/10). On multivariate analysis, female gender, sinonasal, nasopharynx and oropharynx primaries were associated with a greater risk of moderate-severe pain (p < 0.05). Sinonasal, nasopharynx, oral cavity, oropharynx and thyroid primaries were associated with a greater risk of moderate-severe mucositis during radiation (p < 0.0001). Salivary gland, sinonasal, nasopharynx and oropharynx primaries and higher radiation dose were associated with a greater risk of moderate-severe dysgeusia (all p < 0.05).

Conclusions

Electronic PRO collection during H&N cancer RT is feasible. H&N cancer patients experience significant symptoms during RT, and the most severe symptoms reported were dysgeusia, pain and mucositis. Oropharynx cancer patients reported the highest symptom scores during RT.

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Funding

Unrestricted educational grant from Varian Medical Systems.

Author information

Authors and Affiliations

  1. BC Cancer - Vancouver Centre, 600 W 10th Ave, Vancouver, BC, V5K 4E6, Canada

    Sarah Nicole Hamilton, Eric Tran, Cheryl Ho, Eric Berthelet, Jonn Wu, Kimberly DeVries, Vincent LaPointe, Angela Bowman & Minette Lagman

  2. Univeristy of British Columbia, Vancouver, BC, Canada

    Sarah Nicole Hamilton, Eric Tran, Cheryl Ho, Eric Berthelet, Jonn Wu & Robert Olson

  3. BC Cancer - Centre for the North, Prince George, BC, Canada

    Robert Olson

  4. University of Northern British Columbia, Prince George, BC, Canada

    Robert Olson

Authors
  1. Sarah Nicole Hamilton
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  2. Eric Tran
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  9. Minette Lagman
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by SH, VL and KD. The first draft of the manuscript was written by SH, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sarah Nicole Hamilton.

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Conflict of interest

SH, ET, JW, KD, VL, AB and ML report no disclosures. RO has received grants from Varian Medical Systems related to this work. EB has received grants and personal fees from Genzyme and Eisai outside the submitted work. CH reports grants and personal fees from Astra Zeneca, personal fees from Boehringer Ingelheim, personal fees from BMS, personal fees from Roche, personal fees from Lilly, personal fees from Eisai personal fees from Merck and personal fees from Bayer outside the submitted work.

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Approved by institutional REB.

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Informed consent was obtained from all individual participants included in the study.

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Hamilton, S.N., Tran, E., Ho, C. et al. Patient-reported outcome measures in patients undergoing radiotherapy for head and neck cancer. Support Care Cancer 29, 2537–2547 (2021). https://doi.org/10.1007/s00520-020-05778-2

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  • DOI: https://doi.org/10.1007/s00520-020-05778-2

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