Trismus, xerostomia and nutrition status in nasopharyngeal carcinoma survivors treated with radiation Y.-J. CHEN, RN, MS, School of Nursing, College of Medicine, National Taiwan University, Taipei, S.-C. CHEN, RN, PHD, ASSOCIATE PROFESSOR, Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, C.-P. WANG, MD, PHD, ASSOCIATE PROFESSOR, Department of Medicine, College of Medicine, National Taiwan Univer- sity, Taipei, Y.-Y. FANG, RN, MS, School of Nursing, College of Medicine, National Taiwan University, Taipei, Y.-H. LEE, RN, PHD, ASSISANT PROFESSOR, School of Nursing, College of Medicine, National Taiwan University, Taipei, P.-J. LOU, MD, PHD, PROFESSOR, Department of Medicine, College of Medicine, National Taiwan University, Taipei, J.-Y. KO, MD, PHD, PROFESSOR, Department of Medicine, College of Medicine, National Taiwan University, Taipei, C.-C. CHIANG, RN, MS, Department of Nursing, National Taiwan University Hospital, Taipei, & Y.-H. LAI, RN, PHD, PROFESSOR, School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan CHEN Y.-J., CHEN S.-C., WANG C.-P., FANG Y.-Y., LEE Y.-H., LOU P.-J., KO J.-Y., CHIANG C.-C. & LAI Y.-H. (2014) European Journal of Cancer Care Trismus, xerostomia and nutrition status in nasopharyngeal carcinoma survivors treated with radiation The aims of the study were to: (1) examine levels of trismus, xerostomia and nutritional status; (2) compare levels of trismus, xerostomia and nutritional status in patients with nasopharyngeal carcinoma (NPC) receiv- ing different types of radiation modalities; and (3) identify factors related to NPC survivors’ risk status for malnutrition and existing malnutrition. A cross-sectional study with consecutive sampling was conducted. NPC survivors were recruited from otolaryngology/oncology outpatient clinics in a medical centre in Northern Taiwan. Study measures included (1) Mandibular Function Impairment Questionnaire, (2) Xerostomia Ques- tionnaire, (3) Mini Nutrition Assessment, (4) Hospital Anxiety and Depression Scale – Depression subscale, and (5) Symptom Severity Scale. A total of 110 subjects were recruited. Those receiving intensity-modulated radiation therapy had less trismus and xerostomia than patients receiving two-dimensional radiation therapy. Patients with female gender, advanced stage, completion of treatments within 1 year, higher levels of depres- sion, more severe trismus and higher symptom severity tended to have malnutrition or were at risk of malnutrition. Trismus and xerostomia are long-term problems in some NPC survivors and may contribute to malnutrition. To better manage a patient’s trismus and xerostomia and to enhance nutritional status, clini- cians should develop a patient-specific care programme based on careful assessment and targeted measures to improve oral function and insure adequate nutritional intake. Keywords: nasopharyngeal carcinoma, nutrition, trismus, xerostomia, complication. INTRODUCTION Nasopharyngeal carcinoma (NPC) is a geographically linked cancer with high incidence in Southeastern China, Hong Kong and Taiwan (Jeyakumar et al. 2006). In Taiwan, approximately 1500 new NPC cases are reported per year (Health Promotion Administration 2013). Radiation therapy (RT) and concurrent (concomitant) Correspondence address: Yeur-Hur Lai, School of Nursing, College of Medicine, National Taiwan University, 1 Jen-Ai Road, Sec. 1 Taipei, 100, Taiwan (e-mail: laiyhwk@ntu.edu.tw). Conflicts of interest: None declared. Accepted 22 October 2014 DOI: 10.1111/ecc.12270 European Journal of Cancer Care, 2014 Original article © 2014 John Wiley & Sons Ltd