Patients with head and neck cancer who do not receive supportive services are more likely to miss radiation therapy appointments and lose weight during treatment, according to research presented at the 2017 ASCO Annual Meeting (June 2-6, 2017; Chicago, IL).
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Researchers further reported disparities in the receipt of certain services, such as speech and swallowing services, based on hospital type.
Patients receiving treatment for head and neck cancer frequently experience difficulties speaking and swallowing, which can affect their nutrition and overall quality of life. National guidelines recommend that hospitals provide speech, swallowing, and nutrition services to these patients, but little research has focused on the implementation of such programs.
In order to study patterns of supportive services receipt in this patient population, researchers from University of Miami (Miami, FL) conducted a retrospective analysis of 239 patients with nonmetastatic laryngeal or oropharyngeal cancer treated at a safety-net hospital (n = 56) and its affiliated private hospital (n = 138).
A significantly greater proportion of patients treated at the private hospital received speech and swallowing services prior to radiation therapy (54.1% vs 28.6%; P < .001). Both private and safety-net hospitals showed low rates of nutrition services prior to radiation therapy (19.7% vs 14.3%).
A multivariate analysis showed that treatment at a safety-net hospital (P = .029) and longer time to treatment initiation (P = .033) were predictors of a lack of supportive services. Increased likelihood of supportive services receipt was associated with surgery prior to radiation therapy (P = .002) or chemoradiation (P = .001).
A covariate analysis that included race, ethnicity, insurance status, age, gender, and treating hospital found that no covariates were significantly associated with receipt of nutrition services.
Patients who received supportive services were significantly less likely to miss radiation appointments (P = .004), and were less likely to lose weight during treatment (P = .036).—Cameron Kelsall
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