Over 90% of patients with head and neck cancer receiving curative-intent chemoradiation therapy found weekly palliative care visits to be a valuable addition to their treatment, a recent study published by Bauman et al in the Journal of Palliative Medicine found.
Although palliative care is known to improve symptoms and coping in patients with advanced cancer, it hasn’t been evaluated for patients with head and neck cancer receiving curative-intent outpatient chemoradiation therapy at a single care delivery site. Chemoradiation for head and neck cancer is one of the most challenging treatments for patients due to significant side effects, so incorporating better supportive care during treatment is critical.
Effect of the Weekly Visits
Weekly palliative care visits with a focus on symptom management and coping were integrated with oncology care for the study. Palliative care nurses provided the weekly visits; they were supported by palliative care nurse practitioners and palliative medicine physicians where necessary. Twenty of 22 eligible patients were enrolled into the program; patients attended 136 of 138 total visits (96%), and all 20 attended more than 85% of their visits.
A postintervention satisfaction survey was conducted to assess acceptability, symptom burden, mood, and quality of life. Ninety-five percent of patients found the one-on-one format of the intervention and the opportunity to receive additional care “very helpful” and would “definitely recommend” it.
Adding an extra layer of support during very challenging treatment with incorporating a palliative care team into outpatient care for these patients has never been studied, explained first author Jessica R. Bauman, MD, Chief of the Division of Head and Neck Medical Oncology and Assistant Professor in the Department of Hematology/Oncology at Fox Chase Cancer Center.
“We received favorable preliminary data with this pilot study. Now it’s important to study a larger, randomized group of patients to determine how the intervention affects outcomes,” she added, which could help convince health-care systems to invest in such strategies.
Dr. Bauman said she would like to address other questions in a larger study, including whether such interventions can lessen the burden of symptoms and improve mood, and whether the palliative care intervention decreases hospitalizations, thus improving overall care.
The study authors concluded, “Our palliative care intervention during highly morbid chemoradiation therapy was feasible and acceptable with high enrollment, excellent intervention compliance, and high patient satisfaction.”
Disclosure: The pilot study was funded by the Palliative Care Research Cooperative Group. For full disclosures of the study authors, visit liebertpub.com.
