Research on the development and application of bundled care protocols for radiation dermatitis in nasopharyngeal cancer patients.

Abstract

e18123 Background: To develop a bundled care protocol for radiation dermatitis in patients with nasopharyngeal carcinoma (NPC) receiving concurrent chemoradiotherapy (CCRT), and to preliminarily evaluate its clinical efficacy and impact on quality of life (QoL). Methods: Seventy patients with locally advanced NPC undergoing CCRT were enrolled from the Department of Head and Neck Oncology, Affiliated Cancer Hospital of Guizhou Medical University between October 2020 and July 2022. Patients were randomly assigned to an intervention group or a control group. The intervention group received a bundled care protocol in addition to routine nursing care, while the control group received routine care alone throughout CCRT. QoL was assessed using the EORTC QLQ-C30 at three time points: before CCRT, after 15–20 radiotherapy sessions, and at the end of CCRT. The incidence and severity of acute radiation dermatitis and QoL scores were compared between groups. Chi-square test and rank-sum test were used for statistical analysis. Results: The incidence of Grade II acute radiation dermatitis was significantly lower in the intervention group than in the control group (28.57% vs. 51.43%, P < 0.05). No significant differences were observed in Grade I or Grade III dermatitis, and no Grade IV dermatitis occurred in either group. After 15–20 radiotherapy sessions, the intervention group showed significantly higher emotional functioning scores than the control group (P < 0.05). At the completion of CCRT, global QoL, physical functioning, and emotional functioning scores were significantly higher in the intervention group (all P < 0.05). Although fatigue increased in both groups during treatment, fatigue scores were significantly lower in the intervention group at the end of CCRT (P < 0.05). Insomnia scores were also significantly improved in the intervention group compared with the control group (P < 0.05). Conclusions: The bundled care protocol effectively reduced the incidence of acute radiation dermatitis in NPC patients undergoing CCRT and was associated with improved fatigue, sleep quality, physical and emotional functioning, leading to a significant improvement in overall quality of life during treatment.