Retrospective analysis of association of sleep-related symptoms with survival in oropharyngeal cancer radiotherapy survivors

Sleep-related symptoms in head and neck cancer are poorly characterized and often under-recognized. Retrospective analysis of 372 patients with oropharyngeal cancer (OPC) receiving radiotherapy (RT) with or without chemotherapy at MD Anderson Cancer Center (Houston, TX) investigated patient-reported sleep-related symptoms and associations between these symptoms and overall survival (OS). Symptoms were assessed at pre-RT baseline, RT start, RT end, and 6 months post-RT using the MD Anderson Symptom Inventory-Head and Neck. Sever fatigue, sleep disturbance, and drowsiness were infrequent at baseline but peaked at RT end (26%, 15%, and 18%, respectively) and returned to near-baseline levels by 6 months (6%, 4%, and 2%). The figure shows that severe longitudinal fatigue (panel a), sleep disturbance (b), drowsiness (c), and combined symptom burden (d) were associated with worse OS. Severe symptoms at RT start were also associated with worse OS. The authors conclude that severe sleep-related symptoms peaked during RT and were associated with worse OS.