Authors (including presenting author) :
Choy YP(1), Lo YK(1), Shum CY Tracy(1), Cheng CK Ashley(1)
Affiliation :
(1) Department of Oncology, Princess Margaret Hospital
Introduction :
Nasopharyngeal carcinoma (NPC) ranked the 10th common cancers in Hong Kong. The primary treatment of NPC entails radical radiotherapy plus or minus chemotherapy. Radiotherapy to NPC is often associated with high incidence of severe acute toxicities such as oral mucositis, dysgeusia and dermatitis which, if not probably handled, often leads to hospital admission due to a series of medical complications and morbidities. We propose the clinical outcomes of this group of patients can be enhanced by a structured multidisciplinary integrated model of care.
Objectives :
To evaluate the clinical outcomes of NPC patients under the IMSN Head and Neck radiotherapy program and compare the outcomes with the historical data of the same institution before the implementation of the program. Clinical outcomes included the degree of weight loss after radiotherapy, percentage of unplanned hospital admission and percentage of radiotherapy interruption due to acute toxicities.
Methodology :
Clinical and demographic data of NPC patients enrolled into the IMSN Head and Neck radiotherapy program is prospectively collected and reviewed. Comparison is made with historical data of the same institution immediately 3 months prior to the implementation of the program.
Result & Outcome :
One hundred and eighty-two NPC patients are enrolled into the IMSN program from 2nd October 2018 to 31st December 2020.
Forty-one patients are excluded (26 patients RT have not been completed at the time of analysis, 6 patients refused RT in our institution, 9 patients exit program before RT due to death or developed metastatic disease), leaving 140 patients for analysis.
The mean age was 57 (range 28-86) years, male to female ratio was 2.4 to 1. The mean body weight at baseline and at the time of RT completion were 63.7kg and 59.0kg respectively. The mean change of body weight was -7.7%.
The percentage of patients with more than 10% weight loss for the current cohort and the historical data were 28.6% vs. 56% respectively.
It translates into a 49% relative reduction of patients numbers who had significant weight loss after RT.
The percentage of unplanned emergency admission during RT for current cohort and historical data were 8.8% vs. 17.6% respectively. However, the
percentage of RT interruption were both 2.9% and remains unchanged.
Patient satisfactory survey of the IMSN program showed the services are highly rated by the patients and they found the program were in general very helpful. It is especially highly valued in the aspects of providing psycho-social support, facilitation of disease coping, offering in-depth information and a personalized intervention approach.
Conclusion:
IMSN program has significantly improve the clinical outcomes and patients’ satisfaction for NPC patients having radical radiotherapy. The program showed with structured and multidisciplinary care, a significant proportion of patients could prevent severe weight loss and avoid emergency hospital admissions during or after the RT. The program is also highly valued by the patients in satisfaction survey.
