Poster Presentation Joint Scientific Meeting of the Australian & NZ Head & Neck Cancer Society & NZ Association of Plastic Surgeons

A speech pathology service delivery model in radiation oncology for head and neck cancer (1403)

Sally Laing 1 2 , Emma Stradling 1 2 , Molly Barnhart 1 2 , Rachelle Robinson 1 , Virginia Simms 1 , Robert Smee 1 2
  1. Prince of Wales Hospital, Randwick, NSW, Australia
  2. Radiation Oncology, Nelune Comprehensive Cancer Centre, Randwick, NSW, Australia

Purpose: Currently, there is limited evidence addressing speech language pathology (SLP) service delivery in head and neck cancer (HNC).This study aims to demonstrate a service delivery model based on SLP services at Prince of Wales Hospital (POWH).

Method: Cross-sectional analysis of service metrics was conducted on patients receiving HNC intervention at POWH between Jan 2015-Dec 2016. Primary outcome measures were; occasions of service (OOS), clinical hours, and instrumental assessments at each stage of treatment within the first 12 months post treatment. Secondary outcome measures evaluated this service delivery  model using Functional Oral Intake Scale scores and surveys completed by patients, carers and clinicians.

Results: Three clinical hours was the median requirement for all tumour sites at any time point. Care requirements were highest across all tumour sites immediately post treatment between 2.5 - 12.5 hours of service, and again at six months post treatment for the hypopharynx cohort with 6.1 hours of service. Instrumental assessment use was low, >16% of any tumour site, except for the hypopharynx cohort, with 57% of patients requiring modified barium swallow at three months post treatment. Functional swallowing outcomes were equivalent to or better than outcomes identified in the literature. Surveys demonstrated high rates of service satisfaction with 98% of responses reporting the SLP session was useful and 100% of responses reporting they had adequate time in sessions to address concerns.

Conclusion: This study demonstrated the SLP services provided to the HNC cohort at POWH within the first 12 months of treatment. The service patterns were consistent with the known peaks of treatment toxicities, and high service requirements were associated with tumour sites associated with swallowing dysfunction. The service delivery model outlined within this study may assist in the benchmarking and planning of SLP HNC services and is a step towards service standardisation.

Download Presentation