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World J Clin Oncol. Apr 10, 2016; 7(2): 220-226
Published online Apr 10, 2016. doi: 10.5306/wjco.v7.i2.220
Symptom management during and after treatment with concurrent chemoradiotherapy for oropharyngeal cancer: A review of the literature and areas for future research
Heidi Mason, Mary Beth DeRubeis, Nancy Burke, Melissa Shannon, Danielle Karsies, Gregory Wolf, Avi Eisbruch, Francis Worden
Heidi Mason, Mary Beth DeRubeis, Nancy Burke, Melissa Shannon, Danielle Karsies, Gregory Wolf, Avi Eisbruch, Francis Worden, University of Michigan School of Nursing, Ann Arbor, MI 48109-5482, United States
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Conflict-of-interest statement: The authors have no real or potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Heidi Mason, RN, MSN, ACNP-BC, University of Michigan School of Nursing, 400 North Ingalls, Ann Arbor, MI 48109-5482, United States. hmason@med.umich.edu
Telephone: +1-734-2166471 Fax: +1-734-9365525
Received: May 29, 2015
Peer-review started: June 2, 2015
First decision: August 22, 2015
Revised: November 11, 2015
Accepted: January 16, 2016
Article in press: January 19, 2016
Published online: April 10, 2016
Processing time: 314 Days and 2.6 Hours
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.

Keywords: Head and neck cancer; Chemoradiotherapy; Depression; Fatigue; Cachexia; Nausea; Desquamation; Mucositis; Vomiting

Core tip: Patients receiving chemoradiotherpay for head and neck cancer have significant side effects which can interfere with treatment and negatively affect quality of life. While narcotics are often required to treat mucositis pain, adjuvant medication and preventative measures are necessary. Further research in this area is imperative. Dietitians should be readily available for consultation as proper nutrition is crucial. Treatment for nausea and vomiting in the delayed setting as well as for patients who are more sensitive to chemotherapy, needs further attention. Exercise can successfully treat and prevent depression and fatigue. Close monitoring by a multidisciplinary team can ensure adequate symptom management.