Abstract
Although ''depressive'' symptoms decrease by 4 weeks after cessation of radiation treatment (RT), reports indicate that in over 30% of head and neck (HN) cancer patients, fatigue and appetite loss persist for up to 52 weeks, especially in those with advanced stage tumors and radiation or multimodality treatment. This pilot, prospective surveillance study examines the incidence, magnitude and course of fatigue, depression, and neurocognitive dysfunction in patients receiving RT or RT concurrent with systemic agents for squamous cell carcinoma (SCC) of the head and neck (HN). Fifty men and women with SCC of the HN will undergo definitive radiation therapy (60-70 Gy in six to seven weeks) alone (n = 10), or concurrent chemoradiation with cisplatin (n = 20), or concurrent radiation therapy with cetuximab (n = 20). After obtaining informed consent, subjects will be evaluated utilizing self-report questionnaires to assess fatigue (Multidimensional Fatigue Inventory) and depressive symptoms (Inventory of Depressive Symptomatology), as well as a brief, clinician-administered battery of neurocognitive tests (Brief Visuospatial Memory Test, Trails Making Test A and B, and Controlled Oral Word Association) at baseline, midway through treatment (week #3), at the end of treatment (week #6), and finally at 12 weeks after completing treatment. Radiation and medical oncologists will score toxicity and record compliance and tumor response. To evaluate the effects of time (radiation therapy) and systemic agents, two-way analysis of variance for repeated measures will be used. Relevant patient and disease-related variables (including age, cancer stage and site, history of surgery, radiation dose, etc.) will be entered into these analyses as covariates. Data collection and analysis is ongoing. Our findings will expand the limited information regarding the neurobehavioral effects of RT in combination with systemic chemotherapy or biological therapy in patients with SCC of the HN.