S615
Clinical – Head & neck
ESTRO 2026
Purpose/Objective: Advances in head and neck cancer treatment have improved survival, but many patients experience complex, long-term late effects following radiotherapy. These include dysphagia, xerostomia, fibrosis, and psychosocial difficulties, requiring coordinated multidisciplinary management. Despite growing recognition of their impact on quality of life, there is no standardised national framework for assessing, monitoring, or rehabilitating late effects. Current practice varies widely, with inconsistent outcome measurement and unequal access to specialist support. To address this, the Head and Neck Radiotherapy Late Effects Best Practice Guidance Group was established to develop evidence-based multidisciplinary guidelines. A preliminary survey was undertaken to map current practice and identify key priorities to inform this work. Material/Methods: Advances in head and neck cancer treatment have improved survival, but many patients experience complex, long-term late effects following radiotherapy. These include dysphagia, xerostomia, fibrosis, and psychosocial difficulties, requiring coordinated multidisciplinary management. Despite growing recognition of their impact on quality of life, there is no standardised national framework for assessing, monitoring, or rehabilitating late effects. Current practice varies widely, with inconsistent outcome measurement and unequal access to specialist support. To address this, the Head and Neck Radiotherapy Late Effects Best Practice Guidance Group was established to develop evidence-based multidisciplinary guidelines. A preliminary survey was undertaken to map current practice and identify key priorities to inform this work. Results: Twenty-nine members responded, representing a multidisciplinary cohort across the United Kingdom and two international contributors. Professions included speech and language therapy, oncology, radiography, dentistry, physiotherapy, dietetics, nursing, psychology, surgery, and pharmacy, with most participants based in major NHS trusts and academic centres.Overall, 76% reported involvement in or access to a late effects service, though several highlighted the lack of structured pathways. 72% routinely used patient-reported outcome measures (e.g. MDASI, FACIT Fatigue Scale, MDADI), while 48% used clinician-reported outcomes, mainly for lymphoedema and dysphagia. Just over half (52%) had access to radiotherapy plans to support symptom management.Key challenges included inconsistent service provision, workforce pressures, limited guidance, and managing complex multi-symptom needs. Respondents emphasised the need for coordinated, cross-disciplinary guidance and
collaboration with professional bodies and charities such as Oracle, Macmillan and The Swallows. Conclusion: Findings reveal substantial variation in late effects service provision, outcome measurement, and data access across the UK. These results underscore the urgent need for national, evidence-based guidelines and collaborative working across core MDTs to standardise care, improve equity, and embed late effects management within survivorship pathways. Keywords: Late effects, Survivorship, MDT Attendance patterns and impact on swallowing outcomes in head and neck cancer radiotherapy Kate Fitzgerald, Jennifer Murphy, Eoin McGrath, Killian Nugent Radiation Oncology, Cork University Hospital, Cork, Ireland Purpose/Objective: Multidisciplinary care is fundamental in the management of head and neck cancer (HNC), ensuring coordinated decision-making and holistic patient support during radiotherapy (RT) (1). Despite its recognised value, actual attendance and engagement at multidisciplinary appointments (MDAs) are seldom reported, and their clinical implications remain unclear. This study aimed to evaluate attendance patterns at MDAs within a tertiary RT department and to investigate associations between MDA participation, patient characteristics, and swallowing-related toxicities. Material/Methods: A retrospective review was conducted of all HNC patients treated with curative-intent RT between January and December 2024. Attendance was recorded for MDAs involving radiation oncologists, speech and language therapists (SLT), dietitians, radiation therapists, and specialist nurses. Digital Poster 3205 Enhancing multidisciplinary engagement: Demographic data, tumour site and stage, and treatment details were extracted from electronic health records. Acute toxicities, including xerostomia, mucositis, dysgeusia, odynophagia, dysphagia, trismus, skin reaction, and oral intake, were graded according to standard toxicity criteria. Associations between MDA attendance and toxicity grades were assessed using chi-square and logistic regression
analyses. Results:
Ninety-two patients were included. Preliminary data on MDA attendance was 81.6%, with non-attendance most common for SLT appointments (59.7%), often related to treatment fatigue or scheduling constraints.
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