Efficacy of nursing intervention using an adverse event predictive model for head and neck carbon-ion radiotherapy: A prospective clinical study.

Introduction: Radiation dermatitis and oral mucositis are common acute toxicities from carbon-ion radiotherapy (CIRT) for head and neck cancers. These toxicities often impair quality of life (QOL) and can lead to treatment interruption. This study evaluated a dose surface model (DSM) shared by patients and nurses to determine whether it helped patients become more aware of their symptoms and improve their self-care. Methods: This prospective study enrolled 46 patients with head and neck malignancies who underwent CIRT between July 2017 and December 2019. The study program included nurse interviews and administration of the DSM-based patient self-care instructions, which were conducted before treatment, every week during CIRT, and at 1 and 2 months post-treatment. The self-care checklist and daily care frequency data were assessed. QOL was evaluated using the Short Form 8 at baseline, end of CIRT, and 2 months post-CIRT. Results: Radiation dermatitis occurred in 98% of the patients (grades 2-3 in 24%) and oral mucositis in 48% (grades 2-3). The self-care checklist scores improved significantly throughout the latter half of the treatment and post-treatment periods. Self-care frequency did not significantly correlate with adverse event severity, although mouth rinsing frequency tended to increase. Two months after treatment, QOL improved across several domains, particularly mental health. Conclusion: The DSM-based nursing intervention program effectively enhanced patient awareness and confidence in managing radiation-induced skin and mucosal toxicities. This strategy may enhance supportive care and QOL during CIRT for head and neck cancers.