3437 - Research on the Development and Application of Bundled Care Protocols for Radiation Dermatitis in Nasopharyngeal Cancer Patients
Presenter(s)
J. Cao1, G. Chen2, H. Feng2, J. Yang3, Z. Tang2, L. Xing2, Z. Xiong2, Y. Li2, R. Ran2, and F. Jin2; 1Department of Head and Neck Oncology, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, Guizhou, China, 2Department of Head and Neck Oncology, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, China, 3Guizhou Medical University, Affiliated Tumor Hospital of Guizhou Medical University, Guiyang, China
Purpose/Objective(s): To develop a comprehensive bundled care protocol for radiation dermatitis (RD) in patients with nasopharyngeal carcinoma (NPC) and to evaluate its clinical efficacy regarding skin toxicity and health-related quality of life (HRQoL).
Materials/Methods: A randomized controlled trial was conducted involving 70 patients with locally advanced NPC undergoing concurrent chemoradiotherapy (CCRT) at the Affiliated Cancer Hospital of Guizhou Medical University (October 2020 – July 2022). Participants were randomized into an intervention group (n=35) or a control group (n=35). The control group received standard nursing care, while the intervention group received the evidence-based bundled care protocol. RD severity was graded using RTOG criteria. HRQoL was longitudinally assessed using the EORTC QLQ-C30 at three intervals: baseline, mid-treatment (15–20 fractions), and treatment completion. Statistical analyses were performed via chi-square and rank-sum tests.
Results: The bundled care protocol significantly mitigated skin toxicity. At treatment completion, the incidence of Grade II acute RD was significantly lower in the intervention group compared to the control group (28.57% vs 51.43%; P < 0.05). While Grade I and III incidences were comparable between groups, no Grade IV reactions occurred. Regarding HRQoL, the intervention group demonstrated superior emotional function scores mid-treatment ( P < 0.05). By the end of CCRT, the intervention group exhibited significantly higher scores in global quality of life, physical functioning, and emotional functioning compared to controls ( P < 0.05). Furthermore, the intervention group reported significantly lower symptom burden in terms of fatigue and insomnia ( P < 0.05) despite the general trend of treatment-induced exhaustion.
Conclusion: The implementation of a bundled care protocol effectively reduces the severity of acute radiation dermatitis in NPC patients. Beyond physical skin protection, this structured approach alleviates treatment-related fatigue and insomnia, thereby preserving physical and emotional function and enhancing the overall therapeutic experience and quality of life.