Original Article
Trismus, xerostomia and nutrition status in nasopharyngeal carcinoma survivors treated with radiation
Y.-J. Chen RN, MS,
S.-C. Chen RN, PHD,
C.-P. Wang MD, PHD,
Y.-Y. Fang RN, MS,
Y.-H. Lee RN, PHD,
P.-J. Lou MD, PHD,
J.-Y. Ko MD, PHD,
C.-C. Chiang RN, MS,
Y.-H. Lai RN, PhD,
Y.-J. Chen RN, MS
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorS.-C. Chen RN, PHD
Associate Professor
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
Search for more papers by this authorC.-P. Wang MD, PHD
Associate Professor
Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorY.-Y. Fang RN, MS
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorY.-H. Lee RN, PHD
Assisant Professor
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorP.-J. Lou MD, PHD
Professor
Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorJ.-Y. Ko MD, PHD
Professor
Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorC.-C. Chiang RN, MS
Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Y.-H. Lai RN, PhD
Professor
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
Correspondence address: Yeur-Hur Lai, School of Nursing, College of Medicine, National Taiwan University, 1 Jen-Ai Road, Sec. 1 Taipei, 100, Taiwan (e-mail: [email protected]).Search for more papers by this authorY.-J. Chen RN, MS,
S.-C. Chen RN, PHD,
C.-P. Wang MD, PHD,
Y.-Y. Fang RN, MS,
Y.-H. Lee RN, PHD,
P.-J. Lou MD, PHD,
J.-Y. Ko MD, PHD,
C.-C. Chiang RN, MS,
Y.-H. Lai RN, PhD,
Y.-J. Chen RN, MS
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorS.-C. Chen RN, PHD
Associate Professor
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
Search for more papers by this authorC.-P. Wang MD, PHD
Associate Professor
Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorY.-Y. Fang RN, MS
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorY.-H. Lee RN, PHD
Assisant Professor
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorP.-J. Lou MD, PHD
Professor
Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorJ.-Y. Ko MD, PHD
Professor
Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorC.-C. Chiang RN, MS
Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Y.-H. Lai RN, PhD
Professor
School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
Correspondence address: Yeur-Hur Lai, School of Nursing, College of Medicine, National Taiwan University, 1 Jen-Ai Road, Sec. 1 Taipei, 100, Taiwan (e-mail: [email protected]).Search for more papers by this authorConflicts of interest: None declared.
Abstract
The aims of the study were to: (1) examine levels of trismus, xerostomia and nutritional status; (2) compare levels of trismus, xerostomia and nutritional status in patients with nasopharyngeal carcinoma (NPC) receiving different types of radiation modalities; and (3) identify factors related to NPC survivors’ risk status for malnutrition and existing malnutrition. A cross-sectional study with consecutive sampling was conducted. NPC survivors were recruited from otolaryngology/oncology outpatient clinics in a medical centre in Northern Taiwan. Study measures included (1) Mandibular Function Impairment Questionnaire, (2) Xerostomia Questionnaire, (3) Mini Nutrition Assessment, (4) Hospital Anxiety and Depression Scale – Depression subscale, and (5) Symptom Severity Scale. A total of 110 subjects were recruited. Those receiving intensity-modulated radiation therapy had less trismus and xerostomia than patients receiving two-dimensional radiation therapy. Patients with female gender, advanced stage, completion of treatments within 1 year, higher levels of depression, more severe trismus and higher symptom severity tended to have malnutrition or were at risk of malnutrition. Trismus and xerostomia are long-term problems in some NPC survivors and may contribute to malnutrition. To better manage a patient's trismus and xerostomia and to enhance nutritional status, clinicians should develop a patient-specific care programme based on careful assessment and targeted measures to improve oral function and insure adequate nutritional intake.
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