Mucositis-Related Morbidity and Resource Utilization in Head and Neck Cancer Patients Receiving Radiation Therapy With or Without Chemotherapy

Barbara A. Murphy*, Jennifer L. Beaumont, John Isitt, Adam S. Garden, Clement K. Gwede, Andy M. Trotti, Ruby F. Meredith, Joel B. Epstein, Quynh Thu Le, David M. Brizel, Lisa A. Bellm, Nancy Wells, David Cella

*Corresponding author for this work

Research output: Contribution to journalArticle

75 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)522-532
Number of pages11
JournalJournal of Pain and Symptom Management
Volume38
Issue number4
DOIs
StatePublished - Oct 1 2009

Keywords

  • Head and neck cancer
  • functional impairment
  • hospitalization
  • mucositis
  • nutrition
  • patient-reported outcomes
  • resource utilization

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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    Murphy, B. A., Beaumont, J. L., Isitt, J., Garden, A. S., Gwede, C. K., Trotti, A. M., Meredith, R. F., Epstein, J. B., Le, Q. T., Brizel, D. M., Bellm, L. A., Wells, N., & Cella, D. (2009). Mucositis-Related Morbidity and Resource Utilization in Head and Neck Cancer Patients Receiving Radiation Therapy With or Without Chemotherapy. Journal of Pain and Symptom Management, 38(4), 522-532. https://doi.org/10.1016/j.jpainsymman.2008.12.004