Trismus, xerostomia and nutrition status in nasopharyngeal carcinoma survivors treated with radiation

Abstract

The aims of the study were to: (1) examine levels of trismus, xerostomia and nutritional status; (2) compare levels of trismus, xerostomia and nutritional status in patients with nasopharyngeal carcinoma (NPC) receiving different types of radiation modalities; and (3) identify factors related to NPC survivors' risk status for malnutrition and existing malnutrition. A cross-sectional study with consecutive sampling was conducted. NPC survivors were recruited from otolaryngology/oncology outpatient clinics in a medical centre in Northern Taiwan. Study measures included (1) Mandibular Function Impairment Questionnaire, (2) Xerostomia Questionnaire, (3) Mini Nutrition Assessment, (4) Hospital Anxiety and Depression Scale - Depression subscale, and (5) Symptom Severity Scale. A total of 110 subjects were recruited. Those receiving intensity-modulated radiation therapy had less trismus and xerostomia than patients receiving two-dimensional radiation therapy. Patients with female gender, advanced stage, completion of treatments within 1 year, higher levels of depression, more severe trismus and higher symptom severity tended to have malnutrition or were at risk of malnutrition. Trismus and xerostomia are long-term problems in some NPC survivors and may contribute to malnutrition. To better manage a patient's trismus and xerostomia and to enhance nutritional status, clinicians should develop a patient-specific care programme based on careful assessment and targeted measures to improve oral function and insure adequate nutritional intake.

Nutritional Status and Its Association With Radiation-Induced Oral Mucositis in Patients With Nasopharyngeal Carcinoma During Radiotherapy: A Prospective Study

“…Malnutrition is a common problem in NPC patients during RT as a result of gastrointestinal reactions to concurrent chemotherapy, xerostomia, psychological distress, and ROM (21)(22)(23)(24). Severe weight loss and poor physical condition due to malnutrition may lead to CRT interruptions, poor treatment tolerance, and abandonment of concurrent chemotherapy, which eventually impact prognosis (25,26).…”

Intensity-modulated radiation therapy versus 2D-RT or 3D-CRT for the treatment of nasopharyngeal carcinoma: A systematic review and meta-analysis

“…Numerous studies have shown that IMRT can deliver an adequate dose to the gross tumor while sparing the surrounding normal tissues near the nasopharynx such as parotid, temporal lobe, and the brain stem in NPC patients [6,12,14,30,31]. Nevertheless, it is very necessary to have a systematic comparison for the curative effects and side effects between IMRT and conventional 2D-RT to 3D-CRT.…”

Malnutrition According to GLIM Criteria Acts as a Risk Factor for Survival of Nasopharyngeal Carcinoma Patients Undergoing Radiotherapy : A Retrospective Study Highlighting the Nutritional Management in Radiotherapy

“…Undoubtedly, cancer, including NPC, characterize themselves as a cohort of consumptive diseases, which competitively and rapaciously seizure the nutrition due to the enormous energy demands resulting from uncontrollable self-reproduction and proliferation, as a result, heavily uneven distribution of nutrition tilted to tumor cells sparks the consumption of nutrition for cancer patients [21], rendering it understandable that the advanced stage of NPC accompanies the malnutrition before treatment from our result. According to several reports resembling our study, advanced NPC stage cancer patients are more likely to experience weight loss [10,22]. Conceivably, locoregionally advanced tumor progresses for a long period, concurrent with wide deterioration and corresponding symptoms (like loss of appetite, swallowing, and chewing problems) featuring the impediment to caloric intake, which in the end plunges into nutrition shortage and induced malnutritional ultimately.…”