1118 - The Role of Multidimensional Individualized Clinical Management in Radiotherapy for Patients with Head and Neck Cancer: A Prospective Observational Study

Purpose/Objective(s):

Radiation therapy is an important modality for head and neck cancer. Radiotherapy is prone to radiation mucosal injury, followed by malnutrition, and often accompanied by psychological changes, which affect the quality of life of patients. This study was designed to observe the effects of multidimensional individualized clinical management on patients undergoing head and neck radiotherapy by comparing conventional nutritional interventions.

Materials/Methods:

A total of 90 cases with head and neck cancer and radical nasopharyngeal carcinoma who received postoperative radiotherapy at our center from January 2023 to November 2024 were included in this study, and casess with local recurrence or with distant metastases were excluded. The first 50 cases were the control group, and the whole course of radiotherapy was managed according to the conventional clinical management pathway. The latter 40 patients were the research group, and individualized interventions were carried out on the basis of conventional management in four dimensions: nutrition, psychology, living habits, nausea and vomiting. The individualized nutritional interventions were mainly based on the patients' basic cognition of nutritional support, dietary habits and baseline body composition measurements, and were managed in a targeted manner; and immediate adjustments were made according to the patients' responses during radiotherapy. Patients in both groups were evaluated for nutritional assessment (PG-SGA score), oral mucositis, nausea and vomiting, PHQ-9 (anxiety scale), GAD-7 (depression scale), and quality of life (QoL-C30) before (within 1 week before starting), during (week 4), and after radiotherapy (at the end of 1 month).

Results:

Baseline information (age, disease distribution, nutritional status, anxiety and depression, etc.) was not significantly different between the two groups. During radiotherapy, the proportion of moderate-to-severe malnutrition was significantly less in the research group than in the control group (12.0% vs. 50.0%, P = 0.0000); the incidence of severe oral mucositis (G3-4) was significantly less in the research group than in the control group (4.0% vs. 32.5%, P = 0.019); the incidence of nausea and vomiting was significantly less in the research group than in the control group (10.0% vs. 12.5%, 30.0% vs. 30.0% vs. 42.5%, P = 0.003); anxiety and depression scores were significantly lower in the research group than in the control group after radiotherapy (median 15 vs. 17), 15.1 vs. 17.2, P = 0.000); depression scores (median 13 vs. 17), 13.2 vs. 17.1, P = 0.000; overall quality of life was better in the research group than in the control group (median 5.5 vs 7.0) 5.8 vs 7.2.

Conclusion:

Multidimensional individualized clinical management can significantly improve the radiotherapy treatment experience of head and neck cancer patients at the nutritional, symptomatic, and psychological levels and improve the quality of survival.