Chhabria Karishma, Bonnen Mark, Asper Joshua, Carnaby Giselle D
Department of Management, Policy and Community Health, University of Texas Health Science Center, Houston, TX, USA.
Radiation Oncology, University of Texas health Science Center, San Antonio, TX USA.
Int J Oncol Res. 2022;5(2). doi: 10.23937/2643-4563/1710043. Epub 2022 Sep 12.
Head and neck cancer (HNC) patients undergoing chemo/radiation commonly experience severe and persistent distress associated with treatment related fear and physical side effects such as xerostomia, dysphagia, and dryness of mouth. Cortisol, a stress sensitive hormone, can be easily measured in saliva to reflect biobehavioral responses to such stressors. Unfortunately, it has not been used in this population due to concerns associated with chemoradiation (C/RT) related xerostomia.
In a proof-of-concept study, we explored the feasibility of collecting salivary cortisol as a marker of fear and distress in HNC patients. Ten HNC subjects undergoing C/RT provided saliva samples for 3 consecutive days across three timepoints (pre-treatment, 3-weeks and 1-month post-treatment) and completed concurrent depression, anxiety and swallowing related fear measures.
Salivary cortisol collection adherence was between 80-60%. It was not impacted by xerostomia. Diurnal cortisol pattern demonstrated dysregulation at pretreatment in 62%, and flattened aberrant slopes continued at 3-weeks and beyond in 50% of subjects.
Our study supports the feasibility and utility of salivary cortisol measurement in HNC patients across the treatment trajectory. Diurnal cortisol measures may be a valuable tool to detect and monitor treatment distress during C/RT in this population.
接受化疗/放疗的头颈癌（HNC）患者通常会经历与治疗相关的恐惧和身体副作用（如口干、吞咽困难和口腔干燥）相关的严重且持续的痛苦。皮质醇是一种对压力敏感的激素，可以很容易地在唾液中测量，以反映对这些压力源的生物行为反应。不幸的是，由于与放化疗（C/RT）相关的口干问题，它尚未在这一人群中使用。
在一项概念验证研究中，我们探讨了收集唾液皮质醇作为HNC患者恐惧和痛苦标志物的可行性。10名接受C/RT的HNC受试者在三个时间点（治疗前、治疗后3周和1个月）连续3天提供唾液样本，并完成同时进行的抑郁、焦虑和吞咽相关恐惧测量。
唾液皮质醇收集的依从性在80%-60%之间。它不受口干的影响。62%的受试者在治疗前昼夜皮质醇模式显示失调，50%的受试者在3周及以后持续出现异常平缓的斜率。
我们的研究支持在整个治疗过程中对HNC患者进行唾液皮质醇测量的可行性和实用性。昼夜皮质醇测量可能是检测和监测该人群在C/RT期间治疗痛苦的有价值工具。
