Feasibility of symptom monitoring in head and neck cancer follow-up

Introduction: Follow-up of head and neck squamous cell carcinoma (HNSCC) consists of regular clinical examinations and periodic imaging. Symptom monitoring is not integrated in current follow-up strategies. This study aims to assess 1) patients" readiness to periodically report symptoms, 2) feasibility of recruitment for a randomized trial integrating patient reported symptoms in follow-up, 3) user friendliness of a HNSCC-specific symptom questionnaire and 4) compliance with periodic symptom reporting. Materials/Methods: HNSCC patients with complete response were recruited 6 months after treatment in three Swiss centers. Motivation for trial participation was assessed by pre-screening questionnaire. Enrolled patients were randomly assigned to a standard follow-up or to an experimental follow-up with 6-monthly clinical controls without planned imaging. In the experimental arm, patients report symptoms on paper questionnaires monthly. If symptoms trigger predefined alarms, patients are summoned for clinical examination and imaging is acquired if warranted. Results: By September 2023, 35 patients completed pre-screening. Thirty patients (86%) declared interest in participation and 23 (66%) were eventually enrolled, along with four patients who had not completed pre-screening. Potential reduction in periodic imaging was the main motivator for participation (52%). The recruitment goal was reached prematurely. Preliminary analysis of user friendliness showed good acceptance of the symptom questionnaire. A majority (63%) favored transition from paper to digital questionnaires. Up-to-date data on user-friendliness and compliance will be presented. Conclusion: Regular symptom reporting is well received by HNSCC patients. Recruitment for a randomized controlled trial comparing symptom-guided follow-up to the current standard is feasible.

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