Symptom management during and after treatment with concurrent chemoradiotherapy for oropharyngeal cancer: A review of the literature and areas for future research

Abstract

Patients with locally advanced oropharyngeal cancer are at risk for poor outcomes due to the multi-modal nature of treatment and the potential for treatment-related toxicity. Although treatment with concurrent chemotherapy and radiotherapy has drastically reduced the need for a debilitating and disfiguring surgery, treatment related toxicities are often difficult to control. Acute toxicities include mucositis, skin desquamation, depression, cachexia, fatigue and nausea and vomiting. Failure to control these symptoms can adversely affect the patient's ability to complete their treatment regimen. Although there are many promising new treatments in the area of symptom management for this patient population, a review of the literature reflects the need for more research.

Poor Vitamin Status is Associated with Skeletal Muscle Loss and Mucositis in Head and Neck Cancer Patients

“…The treatment of head and neck cancer (HNC) has evolved over the last several decades, with an increased emphasis placed on multimodality management. Despite advances in the management of HNC, treatment-induced toxicities that compromise dietary intake and nutritional status remain a common complication in HNC patients [ 1 ]. Previous studies have suggested that at diagnosis, 42–77% of HNC cancer patients experience malnutrition which is exacerbated over the course of cancer treatment [ 2 ].…”

Modeling symptom drivers of oral intake in long-term head and neck cancer survivors

“…Although HNC cases make up a small percentage of all new cancers in the United States (3%), the survival rates have been steadily increasing in recent years with 5year survival estimated at 65% for oral and pharyngeal cancers and 60% for laryngeal cancers [1,2]. With an increase in survival and intensification of RT with concurrent chemotherapy, there is heightened awareness of the supportive care needs of HNC survivors [3]. A safe and efficient swallow is required for optimal quality of life, nutrition, and to prevent aspiration.…”

Effect of bupivacaine lozenges on oral mucositis pain: a randomized controlled multicenter phase II study

“… 1 At present, no effective pain treatment without substantial side effects exists for patients with severe oral mucositis pain, and in many patients treated with high-dose opioids there is a lack of sufficient pain relief. 8 …”