4.6 Article

Obstructive sleep apnea in head and neck cancer survivors

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SUPPORTIVE CARE IN CANCER
卷 29, 期 1, 页码 279-287

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SPRINGER
DOI: 10.1007/s00520-020-05428-7

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Sleep apnea; Radiotherapy; Head and neck cancer; Treatment-related toxicities

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The study aimed to confirm the prevalence of obstructive sleep apnea (OSA) after radiotherapy for head and neck cancer, as well as investigate the risk factors for developing OSA in this population. The results showed that patients treated for head and neck cancer are at a higher risk of developing OSA, with referral to a sleep clinic recommended for those experiencing fatigue and sleeping problems. Further research is needed to identify potential risk factors and develop prevention and treatment strategies.
Importance Chronic fatigue is present in 33.0% of all head and neck cancer (HNC) survivors; this impacts their quality of life negatively. A plausible cause is obstructive sleep apnea (OSA) after HNC treatment. However, studies regarding this topic are scarce. Objective To confirm if OSA is more prevalent after receiving radiotherapy for HNC. In addition, investigation of the risk factors for developing OSA in this population. Design A retrospective review of prospective data. Methods Treatment for HNC took place between 2016 and 2017 at the University Hospital of Leuven. One hundred sixty-four patients were eligible for participating in this study. Sixty-five responded (39.4%). Upon consulting their medical files, 15 patients were excluded based on the in- and exclusion criteria. Presence of OSA was estimated using standardized questionnaires, namely the Berlin Questionnaire, the Epworth Sleepiness Scale, and the CIS-20. This was compared to the proportion of OSA in the general population. Results Fifty patients (33 men, 17 women) with a mean age of 64.2 years (range 32-88) were included. Based on the questionnaires, OSA was suspected in twenty. The prevalence of suspected OSA in our study group (40.0%) was significantly greater (p < 0.0001) than our estimated prevalence of OSA in the general population (10.9%). No significant risk factors could be identified. Conclusion Patients treated for HNC are at risk of developing OSA. When complaints of fatigue and sleeping problems persist, referral to a sleep clinic is suggested. Further investigation remains necessary to identify potential risk factors along with prevention and treatment strategies.

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