The effects of swallowing disorders, dysgeusia, oral mucositis and xerostomia on oral intake in head and neck cancer patients: A systematic review

Aim of review Combined-modality treatment of head and neck cancer is becoming more common, driven by the idea that organ preservation should both maintain patient appearance and the function of the organ(s) involved. Even if... [ view full abstract ]

Aim of review
Combined-modality treatment of head and neck cancer is becoming more common, driven by the idea that organ preservation should both maintain patient appearance and the function of the organ(s) involved. Even if treatments have improved, they can still be associated with acute and late adverse effects. The aim of this systematic review was to retrieve current data on how swallowing disorders, dysgeusia, oral mucositis and xerostomia affect nutritional status, oral intake, and weight loss in Head and Neck Cancer (HNC) patients.
Search and review methodology
A systematic search of the electronic databases Pubmed, CINAHL, Scopus and Cochrane Library database were searched from January 2005 to May 2015 following the procedure of the Centre for Reviews and Dissemination. Papers were categorized and evaluated according to their methodological quality.
Findings
Initially, 729 papers were retrieved, and after checking the titles and abstracts, 25 publications were considered to be eligible for the purpose of the study, and the full texts were analyzed. Many studies focused on only one symptom at the time, whereas most patients presented all of the four symptoms at the same time.
Conclusions and Implications
Limited data on swallowing disorders, dysgeusia, oral mucositis and xerostomia outcomes for HNC patients are available. Further research is needed to ascertain which aspects of these symptoms should be measured. There is also a lack of well-designed clinical trials, and multicenter and prospective cohort studies. Health care professionals also have to deal with the detection, monitoring and management of the nutritional impact symptoms, with the purpose of helping patients to mitigate and/or manage their effects. The risk of malnutrition can be reduced by knowing the impact of swallowing disorders, dysgeusia, and xerostomia in HNC patients. This knowledge can also improve nursing care.