Longitudinal oncology registry of head and neck carcinoma (LORHAN ^®): Initial supportive care findings

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, ≥ 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.