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

Abstract

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.