Longitudinal oncology registry of head and neck carcinoma (LORHAN): initial supportive care findings. Support Care Cancer 2009 Nov;17(11):1393-401
Date
03/06/2009Pubmed ID
19263090DOI
10.1007/s00520-009-0596-4Scopus ID
2-s2.0-70350173397 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
GOALS OF WORK: We report the first analysis of demographic, socioeconomic, and toxicity data from the Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN).
MATERIALS AND METHODS: Eligible patients include newly diagnosed Head and Neck Cancer (HNC) patients, scheduled to receive radiotherapy or drug therapy, > or =18 years of age, and able to provide informed consent. Assessments are completed at baseline, at the completion of therapy, and yearly thereafter. Patient data are entered in the registry electronically and transferred via Secure HTTP protocols.
RESULTS: Reported use of supportive care differed by treatment setting. When compared to community sites, patients at academic centers received more supportive interventions: feeding tube (59% vs. 48%; p = 0.001), tracheotomy tube (16% vs. 9%; p = 0.002), opioid analgesics (89% vs. 59%; p < 0.0001), anti-emetics (83% vs. 68%; p < 0.0001), and amifostine (17% vs. 12%; p = 0.02). Reported grades 3-4 mucositis/stomatitis was also higher in patients treated at academic centers (38% vs. 28%; p = 0.001).
CONCLUSION: There was a marked decrease in the documented use of supportive care measures in the community setting. This may be due to (1) lower rates of toxicity requiring less supportive care, (2) less stringent documentation, or (3) less aggressive use of supportive care measures. The documented rate of mucositis was less than expected. This is likely due to inadequate assessment or documentation. Further exploration of these findings is warranted as they may indicate an under appreciation and undertreatment of clinically significant acute tumor and treatment-related toxicities.
Author List
Murphy BA, Chen A, Curran WJ Jr, Garden AS, Harari PM, Wong SJ, Ang KKAuthor
Stuart J. Wong MD Center Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAge Distribution
Aged
Aged, 80 and over
Antineoplastic Agents
Combined Modality Therapy
Drug-Related Side Effects and Adverse Reactions
Female
Head and Neck Neoplasms
Humans
Longitudinal Studies
Male
Middle Aged
Palliative Care
Prospective Studies
Radiotherapy
Registries
Socioeconomic Factors
Surveys and Questionnaires
Treatment Outcome