Integrating patient-reported outcomes into routine cancer care: Impact on mucositis management in head and neck cancer (HNC).

347 Background: Patient-reported outcomes (PROs) have demonstrated benefits in oncology. This study aimed to evaluate the impact of incorporating a PRO-based routine on the prevalence and severity of mucositis in patients with HNC undergoing radiotherapy (RT) or chemoradiotherapy (CRT). Methods: This study compared two cohorts of patients with HNC treated at multi-institutional practices in Brazil: a control group assessed by stomatologists using the Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 and a PRO group assessed using the PRO-CTCAE. Eligible patients received comprehensive baseline assessments, including clinical and radiographic dental examinations. Prophylactic photobiomodulation (PBM) therapy was administered during RT sessions to mitigate mucositis. The PRO group captured symptoms such as dry mouth, mouth/throat sores, and difficulty swallowing. Statistical analyses included chi-square tests to compare the incidence of mucositis between groups. Results: The study included 255 patients (control arm: 118; PRO arm: 137), with no significant baseline differences between groups. The median age was 62 years (range, 21–92), with 69% being male and 70% presenting with advanced-stage disease. Primary tumor sites were predominantly the oral cavity (33%) and oropharynx or other locations (37%). Approximately 70% of patients underwent CRT, and 80% of patients in both groups adhered to PBM. The cumulative incidence of any grade mucositis was significantly higher in the control arm (65%) compared to the PRO group (45%; P = 0.04). Similarly, the incidence of grade 3/4 mucositis was higher in the control arm (28%) compared to the PRO group (18%; P = 0.03). In the PRO group, PRO symptoms showed no significant change from baseline to the final assessment. Specifically, the prevalence of dry mouth, difficulty swallowing, and mouth/throat sores decreased only slightly, with 19%, 18%, and 16% of patients reporting these symptoms at the final assessment compared to baseline levels of 10–12%. Conclusions: The integration of PRO-CTCAE into routine care was associated with a significant reduction in the prevalence and severity of mucositis among patients with HNC. These findings underscore the importance of incorporating PROs into clinical practice to enhance symptom management and improve patient-centered care. Prospective studies should explore the mechanisms underlying these improvements.