title: Mucositis-related morbidity and resource utilization in head and neck cancer patients receiving radiation therapy with or without chemotherapy.
abstract: The objective of this study was to estimate health care-resource utilization in head and neck cancer (HNC) patients. This was a prospective, longitudinal, multicenter, noninterventional study of mucositis in patients receiving radiation with or without chemotherapy for HNC. Mouth and throat soreness and functional impairment were measured using the Oral Mucositis Weekly Questionnaire-HNC. Resource utilization data were obtained from patient interviews and recorded from the patient's medical chart. Seventy-five patients were enrolled from six centers. Fifty (67%) patients received concurrent chemoradiation therapy; 34 (45%) received intensity-modulated radiation therapy. Over the course of treatment, 57 (76%) patients reported severe mouth and throat soreness. Pain and functional impairment because of mouth and throat soreness increased during the course of therapy despite the use of opioid analgesics in 64 (85%) of the patients. Complications of radiation therapy resulted in increased patient visits to physicians, nurses, and nutritionists. Thirty-eight (51%) patients had a feeding tube placed. Twenty-eight patients (37%) were hospitalized, five of whom were hospitalized twice; of the 33 admissions, 10 (30%) were designated as secondary to mucositis by their treating physician. Mean length of hospitalization was 4.9 days (range: 1-16). This study demonstrates that mucositis-related pain and functional impairment is associated with increased use of costly health resources. Effective treatments to reduce the pain and functional impairment of oral mucositis are needed in this patient population.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232-5536, USA. jlatham@pharmascribe.com
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Murphy
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.forename: John
authors.initials: J
authors.lastname: Isitt
authors.forename: Adam S
authors.initials: AS
authors.lastname: Garden
authors.forename: Clement K
authors.initials: CK
authors.lastname: Gwede
authors.forename: Andy M
authors.initials: AM
authors.lastname: Trotti
authors.forename: Ruby F
authors.initials: RF
authors.lastname: Meredith
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
authors.forename: Quynh-Thu
authors.initials: QT
authors.lastname: Le
authors.forename: David M
authors.initials: DM
authors.lastname: Brizel
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Bellm
authors.forename: Nancy
authors.initials: N
authors.lastname: Wells
authors.forename: David
authors.initials: D
authors.lastname: Cella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015897:Comorbidity; D004358:Drug Therapy / Q000706:statistics & numerical data*; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000453:epidemiology*; D020266:Radiotherapy, Conformal / Q000706:statistics & numerical data*; D013280:Stomatitis / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States
chemical_list: D000970:Antineoplastic Agents