Unexpected Hospitalizations Result in Unfavorable Outcomes in Head and Neck Cancer

Patients undergoing radiation treatment for head and neck cancers who were unexpectedly hospitalized for dehydration, fever or other ailments were found to be at a higher risk for less favorable outcomes, according to a study published in Oral Oncology.

The research, conducted at Roswell Park Comprehensive Cancer Center, found that patients with head and neck cancers receiving radiotherapy who were hospitalized for fever and/or dehydration either during treatment or within 90 days of receiving radiation were at a higher risk of death from these complications.

“While the trends we found are concerning, they highlight an important clinical indicator that has not received enough attention, and opportunities for improving both health and quality of life for our patients,” lead investigator Anurag Singh, MD, said in a press release.

The experiences of 839 patients collected from Roswell Park between 2003 and 2017 were retrospectively analyzed. Of that population, 171 patients were hospitalized at least once after receiving radiotherapy within 90 days of their initial treatment.

At 5 years, the average overall survival rate for patients unexpectedly hospitalized was 46% compared to 60.4% for patients not hospitalized. More, the cancer-specific survival rate at 5 years was 58.3% for patients unexpectedly hospitalized compared to 70.1% for patients not hospitalized.

The researchers noted that the percentage of patients hospitalized in this study was lower than they expected, the data suggests clinical outcomes for the cohort who was not hospitalized were much better than patients who were hospitalized.

Singh emphasized that clinical teams need to regularly monitor a patient’s overall health. “Providers need to see the patients as frequently as they need to be seen, not just once a week,” Singh explained in a press release.

Of this population, the patients who finished their radiotherapy completely were found to have better overall survival rates and cancer-specific survival rates than those patients who did not complete radiotherapy. More, the complete response to treatment was better for this cohort of patients compared to those who did not complete radiotherapy.

Moving forward, the researchers suggest further investigation into the “significance of hospitalizations as a clinical indicator.” Specifically, they think a multisite study could illuminate any associations between hospitalizations and less-favorable outcomes.

“This research changes how we understand interventions during radiation,” Singh said in a press release. “Based on these findings, we will continue to focus on improving pain control and hydration and at ways we can help make our patients fitter and more resilient with exercise for both health maintenance and improved quality of life.”

Reference:

Number of Hospitalizations Can Be Important Clinical Indicator for Head, Neck Cancer Patients [news release]. Buffalo, New York. Published June 30, 2020. https://www.newswise.com/articles/number-of-hospitalizations-can-be-important-clinical-indicator-for-head-neck-cancer-patients?sc=sphr&xy=10021790. Accessed July 21, 2020.