Pre-treatment psychoeducational intervention and outcomes in head and neck cancer patients undergoing radiotherapy

Nauman H Malik; Manjula Maganti; Maurene McQuestion; Michael C Tjong; Dana Keilty; Eric Monteiro; Shao Hui Huang; Raymond Woo-Jun Jang; Andrea Gomes; Joanne Pun; Jolie Ringash

doi:10.1007/s00520-020-05627-2

Pre-treatment psychoeducational intervention and outcomes in head and neck cancer patients undergoing radiotherapy

Support Care Cancer. 2021 Mar;29(3):1643-1652. doi: 10.1007/s00520-020-05627-2. Epub 2020 Aug 6.

Authors

Nauman H Malik^{1

2}, Manjula Maganti^{3

4}, Maurene McQuestion^{1

2

5}, Michael C Tjong^{1

2}, Dana Keilty^{1

2}, Eric Monteiro⁶, Shao Hui Huang^{1

2}, Raymond Woo-Jun Jang⁷, Andrea Gomes⁸, Joanne Pun^{2

9}, Jolie Ringash^{10

11

12}

Affiliations

¹ Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
² Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
³ Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada.
⁴ University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada.
⁵ Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
⁶ Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.
⁷ Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
⁸ Department of Speech Language Pathology, University of Toronto, Toronto, ON, Canada.
⁹ Clinical Nutrition, Princess Margaret Cancer Centre, Toronto, ON, Canada.
¹⁰ Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada. Jolie.Ringash@rmp.uhn.on.ca.
¹¹ Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada. Jolie.Ringash@rmp.uhn.on.ca.
¹² Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada. Jolie.Ringash@rmp.uhn.on.ca.

PMID: 32761517
DOI: 10.1007/s00520-020-05627-2

Abstract

Background: To investigate the relationship between attendance to a pre-treatment psychoeducational intervention (prehab) with treatment outcomes and toxicities in patients receiving radiotherapy for head and neck cancers (HNCs).

Methods: Patients were included from prehab inception in 2013 to 2017, comparing overall survival (OS), locoregional recurrence-free survival (LRFS), and locoregional recurrence (LRR) between prehab attendees (PA) and non-attendees (PNA). Multivariable analysis was performed for OS and LRFS.

Results: Among 864 PA and 1128 PNA, 2-year OS was 88% vs 80% (p < 0.001), and LRFS was 84% vs 75% (p < 0.001). On multivariable analysis (MVA), OS and LRFS were independently and unfavourably associated with PNA. The PA cohort had a lower frequency of a "rocky treatment course" compared with the PNA cohort (52/150, 35% vs 71/150, 47%; p = 0.034).

Conclusions: Prehab at our institution is associated with improved long-term oncologic outcomes. Prospective data is needed to better understand this association.

Keywords: Head and neck cancers; Quality of life; Radiotherapy; Supportive care; Survivorship.

MeSH terms

Cognitive Behavioral Therapy / methods
Female
Head and Neck Neoplasms / mortality
Head and Neck Neoplasms / radiotherapy*
Humans
Male
Prospective Studies
Retrospective Studies
Survival Analysis
Treatment Outcome