DR. VARSHA RAGHU,DR. NIVEDA RAMACHANDRAN,DR. RAADHIKA SHREE,DR. K. RAMESH
DOI: https://doi.org/Background:
Head and neck cancers (HNCs) are often managed with concurrent chemoradiotherapy (CTRT) in locally advanced stages. While CTRT improves locoregional control, its impact on neurocognitive function in HNC survivors remains underexplored. This study prospectively evaluates cognitive changes in patients undergoing CTRT, using validated screening tools over a 12-month follow-up period.
Methods:
A prospective cohort of 25 patients with biopsy-proven squamous cell carcinoma of the oropharynx, hypopharynx, larynx, or nasopharynx (Stage III–IVA, ECOG 0–2) was recruited. All received definitive CTRT with site-specific radiotherapy protocols and cisplatin-based chemotherapy. Cognitive function was assessed at baseline, and at 3, 6, and 12 months post-treatment using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). Paired t-tests compared follow-up scores with baseline, with significance set at p < 0.05.
Results:
The mean baseline MoCA and MMSE scores were 26.76 ± 1.44 and 28.78 ± 0.87, respectively. Significant cognitive decline was observed at 3 months (MoCA: 23.96 ± 1.40, p < 0.001; MMSE: 27.03 ± 1.08, p < 0.001). Partial recovery occurred by 6 months and continued through 12 months, yet both scores remained significantly lower than baseline at final follow-up (MoCA: 25.30 ± 1.52, p < 0.001; MMSE: 27.78 ± 0.85, p < 0.001). The steepest decline occurred within the first 3 months after CTRT completion.
Conclusion:
CTRT in head and neck cancer patients is associated with measurable cognitive decline, most prominent in the early post-treatment phase, with incomplete recovery at 12 months. Routine cognitive screening in survivorship care may facilitate early detection and timely intervention.
