Background
All head and neck cancer (HNC) patients receiving radiotherapy should have access to Speech and Language Therapy (SLT)1.
As part of a waiting list initiative, a 10-week SLT education group, was piloted in a radiation-oncology (RO) service in 2023, with an aim to increase timely access to SLT.
Methods
HNC patients receiving radical radiotherapy prioritised as low-risk SLT patients (n=22), were invited to attend a session covering an introduction to the mechanics of eating, drinking and swallow (ED&S), side-effects of radiotherapy, management strategies and swallowing exercises.
Data was collected on patient demographics, treatment plans, attendance rates and admissions.
Swallowing outcomes and patient satisfaction levels were also gathered.
Results
14 patients attended (64%). The majority (57%) had disease staging as ≤T2.
5 attendees required admission (36%), compared to 6/8 patients (75%) who were invited and did-not-attend.
Attendees were admitted later into their treatment when compared to non-attendees (mean fraction at time of admission 32 : 23.5; range 28-35 : 13-35).
All attendees reported the session as helpful and would recommend to fellow-patients.
When comparing costings for individual versus group interventions, savings of €482.46 could be made per group programme2.
Conclusion
This initiative provided SLT access for patients who would otherwise not have received guidance.
However, the value and effectiveness of tailored face-to-face SLT interventions with HNC patients who present with complex ED&S needs cannot be underestimated4, 5 and a similar approach may not be appropriate for more extensive disease where individualised input is the gold-standard. 3
Further analysis exploring rationale for non-attendance will assist with future programme design.
References
1 Baijens, L. W. et al (2021) European white paper: oropharyngeal dysphagia in head and neck cancer. European Archives of Oto-Rhino-Laryngology https://doi.org/10.1007/s00405-020-06507-5
2 HIQA (2018) Guidelines for the Economic Evaluation of Health Technologies, Dublin
3 Clarke, P. et al (2016) Speech and swallow rehabilitation in head and neck cancer: United Kingdom national multidisciplinary guidelines. The Journal of Laryngology and Otology 130, S176-S180
4 Patterson J, Wilson JA. The clinical value of dysphagia preassessment in the management of head and neck cancer patients.Curr Opin Otolaryngol Head Neck Surg. 2011;19:177–81. doi:10.1097/MOO.0b013e328345aeb0.
5 Govender, R. et al (2019) Helping Patients with Head and Neck Cancer Understand Dysphagia: Exploring the Use of Video-Animation.American Journal of Speech-Language Pathology Vol 28 697-705
Katie Higgins1, Susan Lawson1, John Armstrong2, Oleksandr Boychak2, Sinead Brennan2, Fran Duane2
1 SLRON, Speech and Language Therapy, Dublin, Ireland
2 SLRON, Radiation Oncology, Dublin, Ireland