Nutritional impact symptoms and associated outcomes in post-chemoradiotherapy head and neck cancer survivors: a systematic review
M., Sarma, K. P., & Arthur, A. E. (2018). PubMed.
Define any terms necessary:
Possible questions to ask your doctor:
Reference: M., Sarma, K. P., & Arthur, A. E. (2018). Nutrition impact symptoms and associated outcomes in post-chemoradiotherapy head and neck cancer survivors: a systematic review. Journal of cancer survivorship : research and practice, 12(4), 479–494. https://doi.org/10.1007/s11764-018-0687-7
Summary written by Avery Singson; Edited by Wendy Liang
March 4th, 2020
Define any terms necessary:
- Nutrition impact symptoms (NIS): impediments likely to compromise eating abilities
- An estimated 90% of head and neck cancer (HNC) patients who undergo chemoradiotherapy develop difficulties with chewing and swallowing and thus experience NIS, which have been proven to negatively affect nutrition and quality of life.
- Despite the impact of these symptoms on patient nutrition, chronic NIS have rarely been systematically studied in long-term HNC survivors.
- The purpose of this systematic review is to assess the current literature on nutrition impact symptoms and their effects on the health and wellbeing of post-chemoradiotherapy head and neck cancer survivors.
- Studies were identified through a keyword search conducted across three databases and were included if they met the specified criteria, which included a 3-month minimum post treatment period.
- Validated measures to assess quality of life and nutrition varied from study to study, and the outcomes were grouped into areas of similarity and reported accordingly for the purposes of this review.
- 15 papers met the set inclusion criteria and were used to assess nutrition and quality of life outcomes among 849 HNC survivors whose long-term effects of chemoradiotherapy included dysphagia, xerostomia, trismus, salivary problems, mucositis, and oral pain.
- 34% of survivors reported difficulties with eating, and diets were overall unbalanced as the consumption of greens, bread, potatoes/rice/pasta/legumes, dairy products, and low-fat margarine was below the recommended intake.
- 4 out of 5 studies that tracked HNC survivors for 5 years and over reported poorer quality-of-life in those unable to consume a typical diet, supporting the relationship between difficulties with food and increased social and emotional distress.
- The studies analyzed in this systematic review confirm that NIS occur in HNC survivors beyond the acute phase of treatment and may negatively impact quality of life.
- It is recommended that large-scale, prospective cohort studies are done in the future to further investigate associations between quality of life in HNC survivors living with chronic NIS as this systematic review is the first to assess NIS beyond the acute phase of treatment.
- Recommendations for healthcare professionals include incorporating swallowing and dietary intervention strategies into follow-up care, continually monitoring survivors for NIS, and educating survivors on how to identify NIS.
Possible questions to ask your doctor:
- What is your plan for monitoring NIS development post-chemoradiotherapy?
- How can I identify NIS on my own?
- How will an unbalanced diet due to NIS affect my life and recovery?
- How will you incorporate swallowing and dietary intervention strategies into my care post-treatment?
- Who will I work with?
- What do these intervention strategies look like?
- For how long will I have to do them?
Reference: M., Sarma, K. P., & Arthur, A. E. (2018). Nutrition impact symptoms and associated outcomes in post-chemoradiotherapy head and neck cancer survivors: a systematic review. Journal of cancer survivorship : research and practice, 12(4), 479–494. https://doi.org/10.1007/s11764-018-0687-7
Summary written by Avery Singson; Edited by Wendy Liang
March 4th, 2020