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Pediatric Otolaryngology

(296) Long-Term Functional Outcomes in Pediatric Head and Neck Cancer Patients

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • PA

    Priya Arya, B.S.

    Medical Student
    Mercer University School of Medicine
    Smyrna, Georgia, United States

    • Co-Author(s)

  • EB

    Emerson Bouldin, MD

    Emory University Department of Otolaryngology, USA

  • NK

    Natalia M. Kuhn, MD

    Medical Corps, United States Navy
    Vista, CA, USA

    • Senior Author(s)

  • KP

    Kara K. Prickett, MD

    Associate Professor
    Emory University Department of Otolaryngology
    Atlanta, GA, United States

Disclosure(s):
Priya Arya, B.S.: No relevant relationships to disclose.
Kara K. Prickett, MD: No relevant relationships to disclose.


Introduction: Pediatric head and neck (H&N) malignancy treatments are multimodal, including traditional photon radiation, chemotherapy, surgery, and proton therapy. These therapies can have significant long-term health and functional consequences for growing patients. We aimed to analyze the current body of knowledge related to long-term functional outcomes for pediatric H&N cancer survivors.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines were followed. Studies not meeting inclusion criteria were excluded using Covidence. 1,356 papers were imported from database search. After individual review by two members and conflict resolution by a senior member, 14 studies were included for review.

Results: Fourteen studies were included. 64% (9/14) papers reported issues with swallowing, characterized as either dysphagia, odynophagia, oropharyngeal fibrosis, esophageal stenosis, xerostomia, trismus, or general issues with the throat and mouth. Six out of 14 papers noted nutritional and feeding deficiencies, and five out of 14 noted issues with speech and voice changes. 29% (4/14) studies reported hearing impairments and/or loss. A majority of papers (9/14) reported long-term function functional characteristics as a secondary outcome. Heterogeneity in methodology and reporting precluded analysis of relationships between treatment type and functional outcomes. Recommendations included regular measurements of QoL parameters during treatment and follow-up, and ensuring measurements are made at baseline and during treatment to evaluate an individual’s progression of QoL throughout care.

Conclusions: The majority of studies demonstrated deficiencies in functional outcomes following treatment of pediatric H&N cancer, with few focusing on these consequences as a primary outcome. This highlights a gap in high-quality evidence in this area. Additionally, there was significant heterogeneity in study methodology, emphasizing the need for standardized methods to assess functional outcomes for pediatric patients treated for H&N cancer.