title: Symptom burden in head and neck cancer: impact upon oral energy and protein intake.
abstract: OBJECTIVE
  This study explored relationships between oral symptom burden (xerostomia, thick secretions, and mucosal sensitivity), energy and protein intake, and weight change over time among head and neck cancer (HNC) patients who have completed concurrent chemoradiation (CCR).
  
  
  METHODS
  Symptom burden was assessed utilizing the Vanderbilt Head and Neck Symptom Survey version 2.0. Weight change was measured from diagnosis to treatment completion, and to the early, mid, and late recovery stage. Energy and protein intake were determined utilizing 24-h diet recalls.
  
  
  RESULTS
  Forty-three adult patients treated for HNC enrolled in the study. Mean percentage weight loss from diagnosis to treatment completion was 7.91 ± 4.06 %. Within the mid-recovery stage significant inverse relationships were found between oral protein intake and xerostomia and mucosal sensitivity (r = -0.818, p = 0.012; r = -0.726, p = 0.032, respectively). After controlling for weight change, significant inverse relationships were found within the mid-recovery stage between oral energy intake and xerostomia and mucosal sensitivity (r = -0.740, p = 0.046; r = -0.751, p = 0.043, respectively). Significant, inverse relationships were also found between oral protein intake and xerostomia and mucosal sensitivity (r = -0.835, p = 0.019; r = -0.726, p = 0.033, respectively).
  
  
  CONCLUSIONS
  Xerostomia and mucosal sensitivity were significantly related to oral energy and protein intake post-CCR in mid-recovery. Weight loss was greatest from diagnosis to treatment completion and continued through the mid-recovery stage. Assessment of oral symptom burden (xerostomia and mucosal sensitivity) and its impact on oral intake and weight post-CCR should be conducted routinely in good patient care.
authors: Minnesota Oncology Hematology PA, 675 East Nicollet Boulevard, Suite 200, Burnsville, MN 55337, USA. heidi.ganzer@usoncology.com
authors: Heidi
authors: H
authors: Ganzer
authors: Riva
authors: R
authors: Touger-Decker
authors: James S
authors: JS
authors: Parrott
authors: Barbara A
authors: BA
authors: Murphy
authors: Joel B
authors: JB
authors: Epstein
authors: Maureen B
authors: MB
authors: Huhmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D002149:Energy Intake; D001068:Feeding and Eating Disorders / Q000150:complications / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000150:complications / Q000209:etiology*; D009061:Mouth Mucosa / Q000378:metabolism / Q000503:physiopathology; D052016:Mucositis / Q000150:complications / Q000209:etiology; D010146:Pain / Q000150:complications / Q000209:etiology; D011446:Prospective Studies; D018434:Sickness Impact Profile; D015431:Weight Loss; D014987:Xerostomia / Q000150:complications / Q000209:etiology