Oral mucositis (OM) related morbidity and resource utilization in a prospective study of head and neck cancer (HNC) patients.

5539 Background: Few studies have reported the burden of oropharyngeal mucositis (OM) as well as the downstream resource consumption and risk of complications due to OM following standard therapy in head and neck cancer patients. This study was a prospective, multi-center, single-arm observational study of patients receiving radiation with or without chemotherapy for head and neck cancer. METHODS: Over a 6-week period, the severity and impact of OM were assessed 5 times with the oral mucositis weekly questionnaire (OMWQ-HN) and patient resource use was collected bi-weekly. Seventy-five patients were enrolled from 6 centers in the United States. Hospitalization costs are reported from the Healthcare Utilization Project Nationwide Inpatient Sample (HUPNIS). RESULTS: Sixty-seven percent (95% CI: 55%-77%) of the patients received concurrent chemoradiation. Seventy-six percent (95% CI: 65%-85%) of patients reported severe mouth and throat soreness. Eighty-five percent (95% CI: 75%-92%) were prescribed opioid analgesics. Mouth pain and throat pain accounted for 78% (95% CI: 68%-86%) of opioid uses. During weeks 1 and 2, 38% (95% CI: 26%-50%) of patients reported severe difficulty swallowing (59% by week 6); 67% (95% CI: 46%-83%) of these patients were taking opioids (84% by week 6). Over half of the patients (38/75; 51% [95% CI: 39%-62%]) had a feeding tube placed. Twenty-eight patients (37% [95% CI: 26%-49%]) were hospitalized, 30% (95% CI: 16%-49%) of hospitalizations were considered related to mucositis. Mean length of stay was 4.9 days (range: 1-16, SE: 0.72). National average cost for a 5-day hospitalization during this study period was approximately $23,000 (SE: $565.00 [HUPNIS]). CONCLUSIONS: Mucositis is a frequent, severe, and costly complication of treatment for head and neck cancer. Effective interventions may not only relieve patient suffering but also reduce healthcare consumption and downstream costs. [Table: see text].

Duke Scholars

Author David Manfield Brizel Radiation Oncology