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...
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| Veröffentlicht in: | Journal of pain and symptom management 2009-10, Vol.38 (4), p.522-532 |
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| creator | Murphy, Barbara A., MD Beaumont, Jennifer L., MS Isitt, John, MS Garden, Adam S., MD Gwede, Clement K., PhD, MPH Trotti, Andy M., MD Meredith, Ruby F., MD Epstein, Joel B., DMD, MSD Le, Quynh-Thu, MD Brizel, David M., MD Bellm, Lisa A., MIM Wells, Nancy, DNSc Cella, David, PhD |
| description | 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. |
| doi_str_mv | 10.1016/j.jpainsymman.2008.12.004 |
| format | Article |
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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.</description><identifier>ISSN: 0885-3924</identifier><identifier>EISSN: 1873-6513</identifier><identifier>DOI: 10.1016/j.jpainsymman.2008.12.004</identifier><identifier>PMID: 19608377</identifier><identifier>CODEN: JSPME2</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anesthesia & Perioperative Care ; Antineoplastic Agents - therapeutic use ; Biological and medical sciences ; Comorbidity ; Drug Therapy - utilization ; Functional impairment ; Head and neck cancer ; Head and Neck Neoplasms - epidemiology ; Head and Neck Neoplasms - radiotherapy ; Health care ; Helpseeking ; hospitalization ; Hospitalization - statistics & numerical data ; Humans ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; mucositis ; nutrition ; Oral health ; Otorhinolaryngology (head neck, general aspects and miscellaneous) ; Otorhinolaryngology. Stomatology ; Pain ; Pain Medicine ; patient-reported outcomes ; Pharmacology. Drug treatments ; Radiation Injuries - epidemiology ; Radiotherapy, Conformal - utilization ; resource utilization ; Stomatitis - epidemiology ; Stomatitis - prevention & control ; Tumors ; United States</subject><ispartof>Journal of pain and symptom management, 2009-10, Vol.38 (4), p.522-532</ispartof><rights>U.S. Cancer Pain Relief Committee</rights><rights>2009 U.S. Cancer Pain Relief Committee</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c631t-6af3dbc938a27a6d2bc51f812609a69f902310ac99c28e328721f803e66babde3</citedby><cites>FETCH-LOGICAL-c631t-6af3dbc938a27a6d2bc51f812609a69f902310ac99c28e328721f803e66babde3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpainsymman.2008.12.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,31000,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22052908$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19608377$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Murphy, Barbara A., MD</creatorcontrib><creatorcontrib>Beaumont, Jennifer L., MS</creatorcontrib><creatorcontrib>Isitt, John, MS</creatorcontrib><creatorcontrib>Garden, Adam S., MD</creatorcontrib><creatorcontrib>Gwede, Clement K., PhD, MPH</creatorcontrib><creatorcontrib>Trotti, Andy M., MD</creatorcontrib><creatorcontrib>Meredith, Ruby F., MD</creatorcontrib><creatorcontrib>Epstein, Joel B., DMD, MSD</creatorcontrib><creatorcontrib>Le, Quynh-Thu, MD</creatorcontrib><creatorcontrib>Brizel, David M., MD</creatorcontrib><creatorcontrib>Bellm, Lisa A., MIM</creatorcontrib><creatorcontrib>Wells, Nancy, DNSc</creatorcontrib><creatorcontrib>Cella, David, PhD</creatorcontrib><title>Mucositis-Related Morbidity and Resource Utilization in Head and Neck Cancer Patients Receiving Radiation Therapy With or Without Chemotherapy</title><title>Journal of pain and symptom management</title><addtitle>J Pain Symptom Manage</addtitle><description>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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia & Perioperative Care</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Comorbidity</subject><subject>Drug Therapy - utilization</subject><subject>Functional impairment</subject><subject>Head and neck cancer</subject><subject>Head and Neck Neoplasms - epidemiology</subject><subject>Head and Neck Neoplasms - radiotherapy</subject><subject>Health care</subject><subject>Helpseeking</subject><subject>hospitalization</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>mucositis</subject><subject>nutrition</subject><subject>Oral health</subject><subject>Otorhinolaryngology (head neck, general aspects and miscellaneous)</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Pain</subject><subject>Pain Medicine</subject><subject>patient-reported outcomes</subject><subject>Pharmacology. Drug treatments</subject><subject>Radiation Injuries - epidemiology</subject><subject>Radiotherapy, Conformal - utilization</subject><subject>resource utilization</subject><subject>Stomatitis - epidemiology</subject><subject>Stomatitis - prevention & control</subject><subject>Tumors</subject><subject>United States</subject><issn>0885-3924</issn><issn>1873-6513</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNks9uEzEQxi0EoiXwCsgcgNMG_8l61xckFAFFagGFVnCzvPYscbprB9tbKTwEz4zTRIA4IE5zmN83M5rvQ-gJJXNKqHixmW-22vm0G0ft54yQdk7ZnJDFHXRK24ZXoqb8LjolbVtXXLLFCXqQ0oYQUnPB76MTKgVpedOcoh8XkwnJZZeqFQw6g8UXIXbOurzD2lu8ghSmaABfZTe47zq74LHz-Ay0vQXeg7nGS-0NRPyxtMHnVFQG3I3zX_FKW3cQXa4h6u0Of3Z5jUO8rWHKeLmGMeRD8yG61-shwaNjnaGrN68vl2fV-Ye375avzisjOM2V0D23nZG81azRwrLO1LRvKRNEaiF7SRinRBspDWuBs7ZhpU04CNHpzgKfoeeHudsYvk2QshpdMjAM2kOYkmrEgpfpghTy2T_JuuG0EbQuoDyAJoaUIvRqG92o405Rova2qY36wza1t01RpoptRfv4uGTqRrC_lUefCvD0COhk9NDH8m-XfnGMkZrJgs7Q8sBBed6Ng6iSKY4YsC6CycoG91_nvPxrihmcd2XxNewgbUogfHFHUZWKQH3a52wfMyL3CVt84T8BxffTTw</recordid><startdate>20091001</startdate><enddate>20091001</enddate><creator>Murphy, Barbara A., MD</creator><creator>Beaumont, Jennifer L., MS</creator><creator>Isitt, John, MS</creator><creator>Garden, Adam S., MD</creator><creator>Gwede, Clement K., PhD, MPH</creator><creator>Trotti, Andy M., MD</creator><creator>Meredith, Ruby F., MD</creator><creator>Epstein, Joel B., DMD, MSD</creator><creator>Le, Quynh-Thu, MD</creator><creator>Brizel, David M., MD</creator><creator>Bellm, Lisa A., MIM</creator><creator>Wells, Nancy, DNSc</creator><creator>Cella, David, PhD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>20091001</creationdate><title>Mucositis-Related Morbidity and Resource Utilization in Head and Neck Cancer Patients Receiving Radiation Therapy With or Without Chemotherapy</title><author>Murphy, Barbara A., MD ; Beaumont, Jennifer L., MS ; Isitt, John, MS ; Garden, Adam S., MD ; Gwede, Clement K., PhD, MPH ; Trotti, Andy M., MD ; Meredith, Ruby F., MD ; Epstein, Joel B., DMD, MSD ; Le, Quynh-Thu, MD ; Brizel, David M., MD ; Bellm, Lisa A., MIM ; Wells, Nancy, DNSc ; Cella, David, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c631t-6af3dbc938a27a6d2bc51f812609a69f902310ac99c28e328721f803e66babde3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesia & Perioperative Care</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Comorbidity</topic><topic>Drug Therapy - utilization</topic><topic>Functional impairment</topic><topic>Head and neck cancer</topic><topic>Head and Neck Neoplasms - epidemiology</topic><topic>Head and Neck Neoplasms - radiotherapy</topic><topic>Health care</topic><topic>Helpseeking</topic><topic>hospitalization</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>mucositis</topic><topic>nutrition</topic><topic>Oral health</topic><topic>Otorhinolaryngology (head neck, general aspects and miscellaneous)</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Pain</topic><topic>Pain Medicine</topic><topic>patient-reported outcomes</topic><topic>Pharmacology. 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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.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19608377</pmid><doi>10.1016/j.jpainsymman.2008.12.004</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of pain and symptom management, 2009-10, Vol.38 (4), p.522-532 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; Applied Social Sciences Index & Abstracts (ASSIA); EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Aged Aged, 80 and over Anesthesia & Perioperative Care Antineoplastic Agents - therapeutic use Biological and medical sciences Comorbidity Drug Therapy - utilization Functional impairment Head and neck cancer Head and Neck Neoplasms - epidemiology Head and Neck Neoplasms - radiotherapy Health care Helpseeking hospitalization Hospitalization - statistics & numerical data Humans Longitudinal Studies Male Medical sciences Middle Aged mucositis nutrition Oral health Otorhinolaryngology (head neck, general aspects and miscellaneous) Otorhinolaryngology. Stomatology Pain Pain Medicine patient-reported outcomes Pharmacology. Drug treatments Radiation Injuries - epidemiology Radiotherapy, Conformal - utilization resource utilization Stomatitis - epidemiology Stomatitis - prevention & control Tumors United States |
| title | Mucositis-Related Morbidity and Resource Utilization in Head and Neck Cancer Patients Receiving Radiation Therapy With or Without Chemotherapy |
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