Sin SY, Chua MLK, Wong SMM, Sommat K, Lin XY, Ng YY, Soong YL. An evaluation of concordance between head and neck advanced practice radiation therapist and radiation oncologists in toxicity assessment for nasopharyngeal carcinoma patients.
Tech Innov Patient Support Radiat Oncol 2021;
19:52-56. [PMID:
34527820 PMCID:
PMC8430423 DOI:
10.1016/j.tipsro.2021.08.001]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/24/2021] [Accepted: 08/05/2021] [Indexed: 12/01/2022] Open
Abstract
Show concordance in toxicity assessment between Head and Neck Advanced Practice Radiation Therapist (APRT) and Radiation Oncologist (RO) for Nasopharyngeal Carcinoma (NPC) patients.
Describe the importance of timely treatment for NPC patients.
Underline the important role development of APRT in complementing the RO.
Different ways of data analysis to support the concordance study.
Background
Weekly toxicity assessments for patients undergoing head and neck (HN) radiotherapy are essential to ensure that acute side effects are appropriately managed in order for patients to complete their treatment in a safe and timely manner. The incorporation of Advanced Practice Radiation Therapist (APRT) led treatment reviews has been reported for various subsites, but there is currently a lack of published literature regarding this role for patients with HN cancer. The purpose of this study is to assess the concordance of toxicity assessments performed during weekly radiotherapy treatment reviews for patients undergoing HN radiotherapy between the HN APRT and Radiation Oncologist (RO).
Methods
Twenty-three patients with nasopharyngeal cancer (NPC) under the care of 3 ROs were recruited from June to December 2018; weekly assessments were independently performed by HN APRT and ROs. The HN toxicity assessment was graded according to the Common Terminology Criteria for Advanced Events v4.0. Both assessors were blinded to each other’s assessments. The percentage agreement of concordance and agreement level were interpreted by Cohen’s Kappa statistic (κ), with the ROs’ assessments deemed as the ‘gold standard’.
Results
The overall concordance for all graded toxicity assessments between HN APRT and ROs was 78.4%. Xerostomia, dysgeusia, pharyngeal pain and dermatitis assessment were evaluated as ‘Good’ with agreement ranging from κ = 0.608–0.640 between the HN APRT and ROs while dysphagia scored an ‘Almost Perfect’ agreement of κ = 0.834. ‘Moderate’ agreement between the HN APRT and ROs was observed for oral pain and mucositis assessment. A scoring discrepancy of 1 and 2 grades was observed in 21.2% and 0.4% for these two toxicities.
Conclusion
There was high concordance in scoring of acute toxicity between the HN APRT and ROs. The results support the continuing involvement of HN APRT in weekly assessments for NPC patients.
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