Neurological and Functional Symtom Burden During Head and Neck Radiotherapy: Interim Patient-Reported Outcomes from a Single-Centre Study

Abstract

Introduction. Radiotherapy (RT) for head and neck cancer (HNC) is associated with acute neu- rotoxic and functional sequelae affecting peripheral nerves, mucosal sensory pathways, speech, and swallowing mechanisms. Many of these symptoms remain under-recognised in oncological practice. Patient-reported outcome measures (PROMs) enable systematic identification of early neurological and functional impairments that emerge during treatment. Methods. A prospective observational study was conducted at the Lithuanian University of Health Sciences Oncology Hospital. Adult HNC patients undergoing active RT completed the EORTC QLQ-C30 and the head and neck–specific module (QLQ-H&N35). Clinically relevant symptom burden was defined as Likert-scale responses of 3 or higher. Descriptive statistics were used to determine the prevalence of functional, neurological, and psychological impairments. Results. Interim analysis included 20 patients (15% female, 85% male). The mean age was 60.5 ± 3.4 years for females and 64.8 ± 7.3 years for males. Clinically relevant emotional dys- function was reported by 41% of patients, and physical impairment by 40%. The most prevalent systemic symptoms were insomnia (60%), pain (57.5%), and fatigue (51.7%). Neurologically ori- ented impairments were frequent: chewing difficulties (55%), sticky saliva (50%), neuropathic pain (46.3%), speech disturbances (46%), coughing (45%), and xerostomia (45%). Sensory dis- turbances were less common (20%). Females tended to report a higher symptom burden across several domains, although the sample size was limited. Conclusions. Active radiotherapy for head and neck cancer is associated with a substantial early neurological and functional symptom burden. Structured integration of patient-reported outcome measures may enhance detection of treatment-related neurofunctional toxicity and support proactive multidisciplinary management within radiotherapy workflows.