Publications by authors named "Jo Ann Fugazzotto"

2 Publications

  • Page 1 of 1

Patient reported outcomes in patients with head and neck cancer treated with concurrent chemoradiation with weekly versus bolus cisplatin.

Head Neck 2020 Dec 19;42(12):3670-3677. Epub 2020 Aug 19.

Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts, USA.

Background: Patient Reported Outcome (PRO) data comparing bolus (B-CP) with weekly (W-CP) cisplatin concurrent with radiation are lacking.

Methods: We performed a retrospective study comparing PRO among 99 patients with head and neck radiation, 26% who received concurrent B-CP and 73% treated with W-CP.

Results: W-CP patients had a higher Charlson comorbidity index (CCI) (P = .004). There were no differences in median cisplatin dose, PROs, percutaneous endoscopic gastrostomy (PEG) dependence or hospitalization between arms. Patients with a greater decline in their self-reported dysphagia score were more often PEG dependent at the end of radiation therapy (P = .03). There was also a trend toward PEG dependence with a higher maximum dysphagia score and greater change in aspiration score (P = .06). The maximum decline in white cell count and absolute neutrophil count were greater in the W-CP group (P = .04, P = .01).

Conclusion: Both B-CP and W-CP are well tolerated. PROs do not suggest a benefit to W-CP.
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http://dx.doi.org/10.1002/hed.26432DOI Listing
December 2020

Ensuring head and neck oncology patients receive recommended pretreatment dental evaluations.

J Oncol Pract 2015 Mar 27;11(2):151-4. Epub 2015 Jan 27.

Brigham and Women's Hospital; Dana-Farber Cancer Institute; Center for Clinical Excellence, Brigham and Women's Hospital, Boston, MA; and Center for Oncology Care at Erie County Medical Center, Buffalo, NY.

Purpose: Head and neck (H&N) cancer therapy can have a detrimental effect on oral health by increasing the risk of dry mouth, dental caries, dental infection, and osteonecrosis of the jaw. Pretreatment dental evaluations are recommended for patients with H&N cancer before radiation therapy to minimize the risk of acute and long-term adverse effects. In an earlier effort to educate patients and community dentists about the importance of pretreatment dental evaluations, we created a dental instructional guide (DIG) that outlines the necessary components of the preradiation dental evaluation. Yet our program did not have a system for documenting which patients received the DIG. The aim of this project was to create a reliable system to ensure that patients are given the DIG before radiation therapy and that such patients are readily identifiable, allowing us to confirm that their dental evaluations are complete before starting treatment.

Methods: We implemented a tracking template within the H&N oncology program at the Dana-Farber Cancer Institute that documents the date, patient, and clinician who gave the DIG. We used the Model for Improvement methodology and performed plan-do-study-act (PDSA) cycles to test and monitor the results of the template implementation.

Results: We showed a significant improvement in the rate of DIG documentation from a baseline of 0% (range, 0% to 0%) to a mean of 53% (range, 0% to 100%) over 3 months (P < .01).

Conclusion: This intervention was the first step in creating a sustainable system for ensuring timely preradiation dental evaluation, thereby decreasing the risk of dental complications from H&N cancer therapy.
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http://dx.doi.org/10.1200/JOP.2014.000414DOI Listing
March 2015