Symptom Clusters and Their Evolving Patterns in Head and Neck Cancer Patients Undergoing Radiotherapy and Chemotherapy: A Scoping Review

Abstract

Objective: To identify the characteristics and research status of symptom clusters in patients with head and neck cancer undergoing radiotherapy and chemotherapy. Design: Scoping review. Methods: Based on the Joanna Briggs Institute scoping review guidelines as the methodological framework, a comprehensive search was performed in PubMed, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure, Wanfang Database, China Biology Medicine Disc, and VIP database on studies focused on symptom clusters in patients with head and neck cancer during chemoradiotherapy from database inception to August 30, 2023. The data extraction and summary of the included literature were performed for analysis. Results: A total of 13 articles were included in our study. The identified elements of symptom clusters covered assessment and analysis methodologies. 25 symptom clusters were identified in patients with head and neck cancer undergoing chemoradiotherapy, with gastrointestinal symptom clusters and head and neck cancer-specific symptom clusters consistently observed. The number of symptom clusters experienced by patients with head and neck cancer increased as treatment progressed. Conclusions: Our findings suggest that multiple symptom clusters dynamically coexist in patients with head and neck cancer undergoing radiotherapy, with the composition of these symptom clusters exhibiting marked heterogeneity across studies. Future studies may explore the development of symptom assessments tailored specifically for head and neck cancer patients undergoing radiotherapy. Advanced analytical techniques, such as machine learning or more advanced statistical methods, could improve the identification of symptom clusters and core symptoms, providing a basis for subsequent symptom management strategies. Strengths and limitations of this study: 1. This study provides the first comprehensive overview of symptoms experienced by HNC patients throughout the course of chemoradiotherapy. 2. This study describes the key symptoms and persistent symptoms experienced by patients with head and neck cancer at different stages of chemoradiotherapy. 3. A formal assessment of publication bias or study quality was not performed. 4. There are no established effective interventions to systematically summarize the symptoms of patients with head and neck cancer undergoing chemoradiotherapy.

Keywords

Head and neck cancer / Chemoradiotherapy / Symptom cluster / Scoping review

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