News | Radiation Therapy | October 20, 2015

Follow-up With Advance Practice Nurses Benefits High-risk Head and Neck Cancer Patients

Study reveals better symptom management results in fewer emergency room visits and hospital admissions

advance practice nurses, radiation therapy follow-up, head and neck cancer patients, ASTRO 2015

San Antonio, October 19, 2015— For high-risk patients who receive chemoradiation therapy for head and neck cancer, frequent follow-up appointments conducted by advance practice nurses (APN) in a clinical outpatient setting allowed for more intensive symptom management. This program resulted in fewer post-treatment emergency room visits and hospital admissions compared to historical outcomes, according to research presented at the American Society for Radiation Oncology’s (ASTRO’s) 57th annual meeting.

Treatments such as radiation therapy (RT) and chemoradiation therapy (CRT) for patients with head and neck cancer can cause various side-effects, resulting in infection risks and complications that may require unplanned emergency room visits or hospital admissions in the immediate post-treatment months.

APNs have post-graduate education in nursing, often in a specific role and/or patient population, allowing them to diagnose and treat illnesses and to prescribe medication.

This study compared the incidence of adverse events (i.e. unplanned emergency room visits and hospital admissions) in 25 high-risk head and neck cancer patients who received post-treatment care at an APN-led, acute-rehabilitation-focused clinic to the incidence of adverse events of 24 head and neck cancer patients who received standard follow-up treatment. The standard follow-up group patients were identified using an approved institutional review board database.

Patients were considered high-risk if they had limited social support, resided in a nursing home, required multiple hydrations during treatment, received a second course of stereotactic body radiation therapy (SBRT) and/or had a feeding tube.

Of the 49 total patients included in the study, 90 percent had stage IV or recurrent cancer. All patients were treated with intensity-modulated radiation therapy (IMRT) or SBRT techniques. RT alone was given to 22 patients (45 percent) and the other 27 patients (55 percent) received radiation therapy with concurrent chemotherapy using either cisplastin or cetuximab.

Compared to patients in the standard follow-up group, patients in the APN clinic group (APNCG) were seen twice as often (1.2 versus 2.0 visits), with the standard follow-up group being seen at four to six weeks post-treatment, then at three months post-treatment. The APNCG patients were seen at two to four weeks post-treatment and every two to four weeks thereafter until symptoms stabilized.

Of the 49 patients studied, 18 experienced adverse events a total of 26 times. Of those 18 who visited the emergency room or were admitted to the hospital, six (33 percent) were receiving frequent follow-up through the APN-led clinic. Patients who were treated with RT alone who were in the APNCG had the most significant decrease in complications with only 16.7 percent experiencing adverse effects versus 60 percent in the standard follow up group. No difference was found in the patients treated with CRT, due to the intensive post-RT follow-up also provided by medical oncology.      

“This study illustrates an important role for APNs in radiation oncology,” said lead study author Bridgett Harr, CNP, Department of Radiation Oncology at Cleveland Clinic. “[APNs] are in a unique position to provide more intensive follow-up care, allowing them to better manage the post-treatment symptoms of high-risk head and neck cancer patients. Not only is there greater patient satisfaction when being managed in an outpatient setting, it is more cost-effective to avoid emergency room or hospital admissions. The APN’s ability to provide high-quality, cost-effective care will play an increasingly vital role in the future of radiation oncology and healthcare.”

For more information: www.astro.org

Related Content

NIH Study of Brain Energy Patterns Provides New Insights into Alcohol Effects

NIH scientists present a new method for combining measures of brain activity (left) and glucose consumption (right) to study regional specialization and to better understand the effects of alcohol on the human brain. Image courtesy of Ehsan Shokri-Kojori, Ph.D., of NIAAA.

News | Neuro Imaging | March 22, 2019
March 22, 2019 — Assessing the patterns of energy use and neuronal activity simultaneously in the human brain improve
ZON-PTC in Clinical Use With RayStation 8B and Hyperscan
News | Treatment Planning | March 19, 2019
Zuid-Oost Nederland Protonen Therapie Centrum (ZON-PTC), Maastricht, Netherlands, recently treated its first patient...
Older Biologic Age Linked to Elevated Breast Cancer Risk
News | Women's Health | March 19, 2019
Biologic age, a DNA-based estimate of a person’s age, is associated with future development of breast cancer, according...
HeartFlow Analysis Successfully Stratifies Heart Disease Patients at One Year
News | CT Angiography (CTA) | March 19, 2019
Late-breaking results confirm the HeartFlow FFRct (fractional flow reserve computed tomography) Analysis enables...
PET Scans Show Biomarkers Could Spare Some Breast Cancer Patients from Chemotherapy
News | PET Imaging | March 18, 2019
A new study positron emission tomography (PET) scans has identified a biomarker that may accurately predict which...
SyncVision iFR Co-registration from Philips Healthcare maps iFR pressure readings onto angiogram.

SyncVision iFR Co-registration from Philips Healthcare maps iFR pressure readings onto angiogram. Results from an international study presented at #ACC19 show that pressure readings in coronary arteries may identify locations of stenoses remaining after cardiac cath interventions.

Feature | Cardiac Imaging | March 18, 2019 | By Greg Freiherr
As many as one in four patients who undergo cath lab interventions can benefit from a technology that identifies the
Non-Contrast MRI Effective in Monitoring MS Patients
News | Neuro Imaging | March 18, 2019
Brain magnetic resonance imaging (MRI) without contrast agent is just as effective as the contrast-enhanced approach...
Bay Labs Announces New Data on EchoGPS, AutoEF AI Software at ACC.19
News | Cardiovascular Ultrasound | March 15, 2019
Artificial intelligence (AI) company Bay Labs announced the presentation of two studies assessing performance of the...
What to Expect from the Proton Therapy Market in 2019-2020
News | Proton Therapy | March 13, 2019
The number of new particle therapy rooms ordered worldwide dropped by almost 20 percent in 2018, according to a new...