MDASI-HN Symptom Profiling for Early-Risk Stratification of Hypoglossal Neuropathy in Survivors of Oropharyngeal Cancer

Can selected MD Anderson Symptom Inventory–Head and Neck (MDASI-HN) symptom items and a derived composite nerve (MDASI-HN-NERVE) score be used to detect and monitor the risk of late lower cranial neuropathy as a delayed treatment sequela in survivors of oropharyngeal cancer?In this cohort study of 1297 patients with oropharyngeal cancer, 6 MDASI-HN items (chewing/swallowing, choking, speech/voice, mucus, fatigue, and dry mouth) showed distinct symptom trajectories by hypoglossal nerve (CN XII) neuropathy status. A MDASI-HN-NERVE score based on these items, as well as a single-item speech/voice score, was significantly associated with CN XII neuropathy risk, with cut-points as early as pretreatment and 3 to 6 months posttreatment able to identify patients at high risk of CN XII neuropathy years later.The study results suggest that MDASI-HN symptom items and the MDASI-HN-NERVE score provide a patient-reported, scalable method for the early detection and longitudinal monitoring of lower cranial neuropathy risk, potentially showing promise as a clinic-ready marker for integration into survivorship care.

Corresponding Author: Katherine Hutcheson, PhD, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1700 Holcombe Blvd, Houston, TX 77030 (karnold@mdanderson.org).

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