S2671
RTT - Patient experience and quality of life
ESTRO 2026
Microbiome Interactions, King's College London, London, United Kingdom
Purpose/Objective: Radiotherapy and surgery for head and neck cancer (HNC) causes early and late adverse effects. Neck fibrosis is a recognised treatment-related side-effect that leads to pain, stiffness, neck and shoulder dysfunction, often persisting after treatment and limiting recovery. Despite its significantly impact on quality of life (QoL), neck fibrosis remains under- recognised by clinicians and inconsistently addressed in rehabilitation.AimsWe aimed to compare clinician- vs patient-reported neck fibrosis and map physiotherapy rehabilitation provision for HNC patients across the United Kingdom (UK). Material/Methods: A retrospective observational study was conducted at a tertiary London HNC Centre. Patients treated with primary chemoradiotherapy (CRT) or post-operative radiotherapy (PORT) for head and neck squamous cell carcinoma with ≥ 1 year of follow-up were included. CTCAE-graded clinician-reported neck fibrosis (CRNF) and patient-reported neck fibrosis (PRNF; in-house score), and Neck Dissection Impairment Index (NDII), were collected at follow-up. Separately, physiotherapy rehabilitation service provision for HNC patients was mapped using an online survey of 44 UK centres (figure 1). Results: Thirty-eight patients were included (n=18 CRT; n=20 PORT). CRNF occurred more frequently in the PORT (55%) vs CRT group (39%), although this difference was not statistically significant (p=0.35). In contrast, PRNF was significantly more frequent in the PORT group (95% vs 60%; OR=11.0, p=0.016). Agreement between CRNF and PRNF was poor (McNemar’s test p=0.009), with patients identifying fibrosis more often than clinicians. PRNF severity correlated significantly with NDII scores (p = 0.018), indicating greater fibrosis severity was associated with poorer function. Over half of patients in both groups reported no symptom improvement post-treatment.Survey responses from 40 physiotherapy departments showed that although 63% provided a rehabilitation programme for PORT patients, 92.5% lacked equivalent services for patients treated with primary radiotherapy, despite 97.5% identifying an unmet need. The most common barriers were staffing (77%), funding (75%) and training (60%).
Conclusion: Neck fibrosis is under-recognised by clinicians during post-treatment follow-up and is associated with poorer function. Although side-effects are more prevalent in patients receiving surgery and radiotherapy, a significant proportion of patients treated with radiotherapy alone also report side- effects affecting QoL, yet their needs are often unmet. Patients identify and report neck fibrosis symptoms more frequently than clinicians, exposing a critical gap in assessment and management which contribute to chronicity and impaired recovery. These findings reveal widespread underassessment and undertreatment of neck fibrosis in HNC across the UK, particularly for radiotherapy-only patients and emphasises the urgent need for nationally implementable standardised physiotherapy rehabilitation programs. Keywords: Quality of life, functional outcomes Quality of life as experienced by prostate cancer survivors more than 15 years after radiotherapy Ulrika Rönningås 1,2 , Per Fransson 1,3 , Anna-Karin Wennstig 2 , Lars Beckman 3 , Beatrice Backman-Lönn 4 1 Department of nursing, Umeå University, Umeå, Sweden. 2 Department of oncology, Sundsvall hospital, Sundsvall, Sweden. 3 Cancercentrum, Norrlands University Hospital, Umeå, Sweden. 4 Department of health sciences, Mid Sweden University, Sundsvall, Sweden Purpose/Objective: Men who had radiotherapy for prostate cancer often live for many years after treatment. While long-term Digital Poster 2930
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