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Eur J Cancer Care (Engl). 2016 May;25(3):440-8. doi: 10.1111/ecc.12270. Epub 2014 Dec 11.

Trismus, xerostomia and nutrition status in nasopharyngeal carcinoma survivors treated with radiation.

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School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.


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.


complication; nasopharyngeal carcinoma; nutrition; trismus; xerostomia

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