Pre-radiotherapy multidisciplinary survivorship care and patient-reported outcomes in head and neck cancer survivors.

PURPOSE: This study aims to evaluate the association between receiving pre-radiotherapy multidisciplinary survivorship care and patient-reported outcomes measures (PROMs) pertaining to quality of life (QOL), symptom burden, and psychological distress at one-year post-radiotherapy among head and neck cancer (HNC) survivors. METHODS: Survivors who underwent radiotherapy from 2017-2022 and completed PROMs during their one-year post-radiotherapy visit at a multidisciplinary HNC survivorship clinic were included. Survivors with recurrent disease, second primary tumor, and/or distant metastasis were excluded. Differences in PROMs between propensity score matched survivors who did and did not have a pre-radiotherapy visit were analyzed using multivariable regression models controlling for covariates. RESULTS: 310 survivors were included (mean [SD] age, 61.09 [9.58] years; 238 [76.8%] male; 159 [51.3%] pre-radiotherapy visit; 163 [52.6%] oropharyngeal; 161 [54.9%] early T stage; 159 [51.5%] early N stage). Compared to survivors without a pre-radiotherapy visit, survivors with a pre-radiotherapy visit had higher physical (+ 7.26 points, 95% CI [3.35, 11.18], p < 0.001) and social-emotional (+ 5.93 points, 95% CI [1.58, 10.29], p = 0.008) QOL scores and lower depression (-1.31 points, 95% CI [-2.61, -0.01], p = 0.048), anxiety (-1.18 points, 95% CI [-2.23, -0.13], p = 0.027), dysphagia (-3.77 points, 95% CI [-6.36, -1.19], p = 0.004), insomnia (-2.76 points, 95% CI [-4.61, -0.92], p = 0.004), and neck disability (-2.28 points, 95% CI [-4.41, -0.16], p = 0.035) scores one-year post-radiotherapy. CONCLUSIONS: Receiving pre-radiotherapy multidisciplinary survivorship care was associated with higher QOL and lower symptom burden and psychological distress among HNC survivors. These findings support implementing proactive survivorship care in clinical practice to improve health outcomes in HNC.

Duke Scholars

Author Yvonne Marie Mowery Radiation Oncology