{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T03:06:05Z","timestamp":1782702365624,"version":"3.54.5"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,11,4]],"date-time":"2014-11-04T00:00:00Z","timestamp":1415059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The treatment of head and neck cancer (HNC) may cause substantial local and systemic symptomatic morbidities, but many patients have high symptom levels before treatment begins. Knowledge of disease\u2010related (treatment\u2010naive) symptom status would aid in the evaluation of the symptomatic benefit or burden of HNC therapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors retrospectively examined symptoms, quality of life, and health status reported by patients with HNC who were naive to any treatment. Symptoms were explored by anatomical site and disease factors were correlated with symptom severity and interference. A clustering algorithm was used to identify a subset of highly symptomatic patients, and the effects of disease site, tumor stage, and demographic variables on membership in this high\u2010symptom group were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 748 treatment\u2010naive patients with mucosal (434 patients), nonmucosal (272 patients), or skull base (42 patients) tumors were identified who had rated their symptoms using the MD Anderson Symptom Inventory. The majority of patients were white non\u2010Hispanic (82%) and male (68%), with a median age of 59 years. Approximately one\u2010third the patients had a high pretreatment symptom burden. Pain, fatigue, distress, and disturbed sleep were the most severe symptoms reported, regardless of tumor stage or site. Symptom burden was found to be higher among patients with more advanced disease. Predictors of a high symptom burden included having a mucosal tumor and being female.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The high prevalence of moderate to severe symptoms found in the current study demonstrates the importance of assessing patient\u2010reported symptoms routinely before treatment is initiated and emphasizes the need for symptom management in parallel with disease treatment. Baseline characterization of symptom status should be incorporated into clinical trials that may affect symptom burden. <jats:bold><jats:italic>Cancer<\/jats:italic> 2015;121:766\u2013773.<\/jats:bold> \u00a9 <jats:italic>2014 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.29097","type":"journal-article","created":{"date-parts":[[2014,11,4]],"date-time":"2014-11-04T10:28:34Z","timestamp":1415096914000},"page":"766-773","source":"Crossref","is-referenced-by-count":66,"title":["The symptom burden of treatment\u2010naive patients with head and neck cancer"],"prefix":"10.1002","volume":"121","author":[{"given":"Ehab Y.","family":"Hanna","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tito R.","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Department of Symptom Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David I.","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Brandon","family":"Gunn","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Sehra","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Yucel","sequence":"additional","affiliation":[{"name":"Department of Symptom Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles S.","family":"Cleeland","sequence":"additional","affiliation":[{"name":"Department of Symptom Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,11,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27744"},{"key":"e_1_2_7_3_1","first-page":"1634","article-title":"Assessing symptom distress in cancer patients: the M.D","volume":"89","author":"Cleeland CS","year":"2000","journal-title":"Anderson Symptom Inventory. 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