S1430
Interdisciplinary - Health economics & health services research
ESTRO 2026
https://doi.org/10.1186/s12874-020-01078-9 Keywords: prostate, socioeconomic, population-level data
level of toxicity events. Results:
Toxicity requiring hospitalisation within 2 years of treatment was highest in the most deprived quintile (16%) and lowest in the least deprived (12%). Observed medication use within 2 years of treatment also varied across SIMD quintiles (36.4%-39.4%) and was more heterogeneous than predicted toxicity (37.1%-37.6%) (Figure 1). O/E ratios were below 1 in the most deprived quintiles and above 1 in the least deprived (Figure 2), indicating that patients in poorer areas, despite experiencing higher levels of severe toxicity, were accessing disproportionately fewer medications.
Digital Poster 4807 A coordinated multidisciplinary supportive care pathway in head and neck radiotherapy William Gehin 1 , Maria Jolnerovski 1 , Jennifer Martin 1 , Anne Schmitt 2 , Anaïs Beldjoudi 3 , Sophie Renard 1 , Jean- Christophe Faivre 1 , Juliette Jacques 1 1 Radiotherapy, Institut de Cancérologie de Lorraine, Nancy, France. 2 Nutrition Department, Institut de Cancérologie de Lorraine, Nancy, France. 3 Speech and Language Therapy, Institut de Cancérologie de Lorraine, Nancy, France Purpose/Objective: Head and neck radiotherapy frequently causes acute toxicities such as mucositis, dermatitis, dysphagia, trismus and malnutrition, requiring complex supportive management. Although advanced practice nursing (APN), photobiomodulation (PBM), nutritional support and speech therapy have each shown efficacy, they are often delivered separately. The purpose of this project was to design and implement a coordinated, patient-centred pathway integrating these four interventions within a single organisational framework, aiming for earlier management of treatment-related toxicities and enhanced multidisciplinary collaboration. Material/Methods: In 2023–2024, a multidisciplinary team including radiation oncologists, advanced practice nurses, dietitians, speech therapists and radiation therapists co-designed a structured supportive care pathway embedded within the radiotherapy workflow. A dedicated coordination cell schedules all supportive care appointments at the time of treatment planning, aligning weekly APN consultations, systematic PBM sessions performed by trained radiation therapists, and dietetic and speech therapy follow-ups. Regular coordination meetings ensure communication and continuous adaptation of the pathway. Results: Between August 2024 and August 2025, 223 patients with head and neck cancer were included. Over this period, 3,125 PBM sessions ( ≈ 14 per patient), 1,203 APN consultations ( ≈ 5 per patient), 792 dietetic consultations ( ≈ 3.5 per patient) and 682 speech therapy sessions ( ≈ 3 per patient) were performed. The pathway was successfully integrated into routine workflow and well accepted by both patients and professionals. Conclusion: An integrated supportive care pathway combining
Conclusion: Medication information within a population-level data set has been used to identify GI and GU toxicities, providing insight beyond ICD-10 hospital admissions for toxicity. The discrepancy between higher hospital toxicity and relatively lower medication use in deprived areas highlights potential inequities in community management, further exemplified by the lower than predicted medication use in more deprived areas. This suggests that toxicity may go unaddressed unless severe, potentially due to healthcare hesitancy, challenges in access, or other socio-economic barriers [1]. Using EHR data to infer toxicity rather than CTCAE/RTOG is promising, however, more validation is required. References: [1] Lemanska, A., Byford, R.C., Cruickshank, C. et al. Linkage of the CHHiP randomised controlled trial with primary care data: a study investigating ways of supplementing cancer trials and improving evidence- based practice. BMC Med Res Methodol20, 198 (2020).
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