Temporal patterns of patient-reported trismus and associated mouth-opening distances in radiotherapy for head and neck cancer: A prospective cohort study Journal Article
| Authors: | Thor, M.; Olsson, C. E.; Oh, J. H.; Hedström, J.; Pauli, N.; Johansson, M.; Deasy, J. O.; Finizia, C. |
| Article Title: | Temporal patterns of patient-reported trismus and associated mouth-opening distances in radiotherapy for head and neck cancer: A prospective cohort study |
| Abstract: | Objectives: To identify temporal patterns of patient-reported trismus during the first year post-radiotherapy, and to study their associations with maximal interincisal opening distances (MIOs). Design: Single institution case series. Setting: University hospital ENT clinic. Participants: One hundred and ninety-six subjects who received radiotherapy (RT) for head and neck cancer (HNC) with or without chemotherapy in 2007-2012 to a total dose of 64.6/68 Gy in 38/34 fractions, respectively. All subjects were prospectively assessed for mouth-opening ability (Gothenburg Trismus Questionnaire (GTQ), European Organization for Research and Treatment of Cancer quality of life Questionnaire (EORTC QLQ-H&N35), and MIO) pre-RT and at 3, 6 and 12 months after RT. Main outcome measures: Correlations between temporally robust GTQ symptoms and MIO as given by Pearson's correlation coefficients (Pr); temporally robust GTQ-symptom domains as given by factor analysis; rates of trismus with respect to baseline by risk ratios (RRs). Results: Four temporally robust domains were identified: Eating (3-7 symptoms), Jaw (3-7), Pain (2-5) and Quality of Life (QoL, 2-5), and included 2-3 persistent symptoms across all post-RT assessments. The median RR for a moderate/severe (>2/>3) cut-off was the highest for Jaw (3.7/3.6) and QoL (3.2/2.9). The median Pr between temporally robust symptoms and MIO post-radiotherapy was 0.25-0.35/0.34-0.43/0.24-0.31/0.34-0.50 for Eating/Jaw/Pain/QoL, respectively. Conclusions: Mouth-opening distances in patients with HNC post-RT can be understood in terms of associated patient-reported outcomes on trismus-related difficulties. Our data suggest that a reduction in MIO can be expected as patients communicate their mouth-opening status to interfere with private/social life, a clinical warning signal for emerging or worsening trismus as patients are being followed after RT. © 2017 John Wiley & Sons Ltd |
| Keywords: | adult; cancer chemotherapy; middle aged; major clinical study; cancer radiotherapy; prospective study; disease association; cohort analysis; patient monitoring; risk factor; questionnaire; eating; disease severity; head and neck cancer; radiation dose fractionation; university hospital; trismus; correlational study; mouth pain; patient-reported outcome; jaw pain; quality of life assessment; human; male; female; priority journal; article; outcomes < general; quality of life < general; jaw opening reflex |
| Journal Title: | Clinical Otolaryngology |
| Volume: | 43 |
| Issue: | 1 |
| ISSN: | 1749-4478 |
| Publisher: | Blackwell Publishing |
| Date Published: | 2018-02-01 |
| Start Page: | 22 |
| End Page: | 30 |
| Language: | English |
| DOI: | 10.1111/coa.12896 |
| PROVIDER: | scopus |
| PUBMED: | 28463432 |
| PMCID: | PMC6651728 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 6 February 2018 -- Source: Scopus |
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