Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;42(8):2137-2144.
doi: 10.1002/hed.26151. Epub 2020 Mar 25.

Neurologic sequelae following radiation with and without chemotherapy for oropharyngeal cancer: Patient reported outcomes study

Adam S Garden  1 , Mona Kamal  1   2 , Abdallah S R Mohamed  1   3 , Steven J Frank  1 , Jan S Lewin  4 , Stephen Y Lai  4 , William H Morrison  1 , Jack Phan  1 , Renata Ferrarotto  5 , David I Rosenthal  1 , Katherine A Hutcheson  4 , Clifton D Fuller  1 , Gary B Gunn  1
Affiliations

Neurologic sequelae following radiation with and without chemotherapy for oropharyngeal cancer: Patient reported outcomes study

Adam S Garden et al. Head Neck. 2020 Aug.

Abstract

Background: There is little data describing neurocognitive late sequelae in patients treated for oropharyngeal cancer.

Methods: Using PROs, scores for "numbness/tingling" and "difficulty remembering" were assessed. Wilcoxon testing was utilized to compare mean assessment scores (1-10) between treatment subgroups.

Results: Four-hundred ninety-seven patients were evaluated and 267 (54%) received chemotherapy. The mean score for numbness/tingling for patients receiving radiation alone was 0.99 and for each chemotherapy subgroup were: Induction chemotherapy (IC), 1.35 (n = 99); concurrent chemotherapy (CCRT), 1.04 (n = 111) and IC + CCRT, 2.48 (n = 57); 30% of patients who received IC + CCRT had scores ≥5. The mean scores for difficulty remembering were XRT: 1.44, chemotherapy: 1.45, and IC + CCRT subgroup: 2.42.

Conclusions: The symptom burden related to peripheral neuropathy and cognitive complaints was minimal. A minority of patients reported high burdens. Particularly, 30% of patients receiving IC + CCRT described moderate to severe numbness/tingling.

Keywords: chemoradiation; cisplatin; radiation; taxane.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST The authors declare no potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Box and whisker plots of patient reported scores (0–10) of “numbness/tingling.” C, concurrent chemoradiation; I, induction chemotherapy; I + C, induction chemotherapy and concurrent chemoradiation; X, radiation only
FIGURE 2
FIGURE 2
Bar plots of frequency of patient reported scores ≥5 of “numbness/tingling.” C, concurrent chemoradiation; I, induction chemotherapy; I + C, induction chemotherapy and concurrent chemoradiation; X, radiation only
FIGURE 3
FIGURE 3
Box and whisker plots of patient reported scores (0–10) of “trouble remembering.” C, concurrent chemoradiation; I, induction chemotherapy; I + C, induction chemotherapy and concurrent chemoradiation; X, radiation only
FIGURE 4
FIGURE 4
Bar plots of frequency of patient reported scores ≥5 of “trouble remembering.” C, concurrent chemoradiation; I, induction chemotherapy; I + C, induction chemotherapy and concurrent chemoradiation; X, radiation only
See this image and copyright information in PMC

References

    1. Pignon JP, le Maitre A, Maillard E, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol. 2009;92:4–14. - PubMed
    1. Cohen EE, Karrison TG, Kocherginsky M, et al. Phase III randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer. J Clin Oncol. 2014;32:2735–2743. - PMC - PubMed
    1. Haddad R, O’Neill A, Rabinowits G, et al. Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): a randomised phase 3 trial. Lancet Oncol. 2013;14:257–264. - PubMed
    1. Worden FP, Kumar B, Lee JS, et al. Chemoselection as a strategy for organ preservation in advanced oropharynx cancer: response and survival positively associated with HPV16 copy number. J Clin Oncol. 2008;26:3138–3146. - PMC - PubMed
    1. Chen AM, Felix C, Wang PC, et al. Reduced-dose radiotherapy for human papillomavirus-associated squamous-cell carcinoma of the oropharynx: a single-arm, phase 2 study. Lancet Oncol. 2017;18:803–811. - PMC - PubMed

Publication types

MeSH terms