Survivorship therapy needs after radiotherapy for head and neck cancer: surveying opportunities for growth (STRONG).

INTRODUCTION

Patients with head and neck squamous cell carcinoma (HNSCC) are at risk for long-term side effects and require thorough survivorship care following completion of radiation therapy (RT). We aimed to identify survivorship interest and needs following RT.

METHODS

Patients with HNSCC who completed RT from Jan 2013 to April 2023 completed questions based on the five-domain Cancer Survivorship Framework (physical effects, psychosocial effects, cancer screening, chronic conditions, health promotion) and the Consolidated Framework for Implementation Research (interest, knowledge, barriers).

RESULTS

Of 1,123 patients, 317 participated (response rate 28%). Patients were 64% (n = 203) male with a mean age of 64 years (SD 12), with 66% (n = 209) finishing treatment > 2-years prior. 36% (n = 115) were interested in, 34% (n = 108) prioritized, and 28% (n = 88) had information related to survivorship. For survivorship domains, within physical effects, dry mouth (40%, n = 126) and trouble swallowing (24%, n = 75) were most bothersome. For psychosocial, 15% (n = 46) reported current depression (mean PHQ2 score ≥ 3) and 71% (n = 226) felt mental health needs were not addressed during treatment. Forty-two percent felt that diet, exercise, and smoking were not addressed (n = 134). Seventy-six percent (n = 240) understood the importance of cancer screening. Most patients wished to address survivorship topics in one long visit (45%, n = 142) and preferred in-person visits (60%, n = 190). Potential barriers included insurance coverage and scheduling concerns.

CONCLUSION

In post-RT HNSCC survivors, survivorship interest and knowledge were limited. There is a need for education on survivorship.

IMPLICATIONS

These findings provide a foundation for developing robust survivorship care programs that meet the diverse needs of this patient population.