Subjective functional outcomes in oropharyngeal cancer treated with induction chemotherapy using the MD Anderson Symptom Inventory (MDASI). Issue 6 (6th November 2020)

• Record Type: Journal Article
• Authors: Mott, Frank E.; Sacks, Ruth; Johnson, Faye; Hutcheson, Katherine A.; Gallagher, Natalie; Varghese, Susan; Zaveri, Jhankruti
• Is Part Of: Laryngoscope investigative otolaryngology. Volume 5:Issue 6(2020)
• Page Start: 1104
• Page End: 1109
• Publication Date: 2020-11-06
• Subjects: induction chemotherapy -- oropharyngeal carcinoma -- patient outcomes; Otolaryngology -- Periodicals; Laryngoscopy -- Periodicals; Otolaryngology; Otolaryngology; Periodicals; Periodicals; 617.51
• DOI: 10.1002/lio2.487
• Languages: English
• ISSNs: 2378-8038

Abstract

Abstract: Objectives: Evaluate the use of induction chemotherapy (IC) in oropharyngeal cancer (OPC) and its impact on subjective functional outcomes using a validated MD Anderson Symptom Inventory‐Head and Neck (MDASI‐HN) survey tool. Methods: A single institution retrospective review of OPC patients who received IC, including reasons given for using IC, regimens employed, responses, and patient‐reported outcomes (PRO). The latter included pain, distress, dysphagia, xerostomia, and feeding tube placement and dependency. PRO's were assessed using the validated MD Anderson Symptom Inventory‐Head and Neck (MDASI‐HN) conducted at baseline, during treatment, and at six‐month follow up. Results: One hundred and twenty‐five patients were evaluable. They were more likely to have large primary and/or bulky or low neck nodal disease as a reason for IC. A taxane‐containing regimen was most common. Primary tumor response was seen in 83.2% and the nodal response in 81.6%. Pain and xerostomia improved with IC, dysphagia was not adversely affected with IC. These symptoms all increased with consolidation chemoradiotherapy (CRT) but returned to baseline by 6 months post treatment. Feeding tube placement did not increase with IC but did with CRT, most patients were no longer feeding tube dependent at 6 months. Conclusion: This retrospective review of subjective functional outcomes, especially swallowing and feeding tube dependency, using the MDASI survey tool in 125 oropharyngeal cancer patients with large primary tumors and/or bulky adenopathy treated predominantly with platinum‐taxane based induction chemotherapy showed that such outcomes were not adversely impacted. While not standard, such approach may be beneficial in such patients. Level of Evidence: 2. Abstract : HPV‐positive oropharyngeal cancer typically has a good survival prognosis. Standard treatment with radiation and chemotherapy, while curative, can produce long term dysfunctional outcomes. Induction chemotherapy has not been shown to improve overall survival but is occasionally used in patients with high stage and/or aggressive disease. we looked at the impact of induction chemotherapy on subjective functional outcomes.