PURPOSE There are no evidence-based guidelines informing which patients with head and neck cancer (HNC) require regular speech pathology (SP) support during radiation treatment (RT). Hence, some services use a "one-size-fits-all" model, potentially over-servicing those patients at low risk for dysphagia. This study evaluated the clinical safety and efficiency of an interdisciplinary service model for patients identified prospectively as "low risk" for dysphagia during RT. METHODS A prospective cohort of 65 patients with HNCs of the skin, thyroid, parotid, nose, and salivary glands, receiving curative RT, were managed on a low-risk pathway. Patients with baseline dysphagia (functional oral intake score ≤ 5) were excluded. The model involved dietitians conducting dysphagia screening at weeks 3, 5, and 6/7 within scheduled appointments. Patients at risk of dysphagia were referred to SP for assessment, then management if required. To validate the model, SP assessed swallow status/toxicities at week 5/6/7 during RT and confirmed dysphagia status at weeks 2 and 6 post RT. RESULTS Most (89.3%) patients did not require dysphagia support from SP services. Of the 18 patients identified on screening, only 7 (10.7%) had sufficient issues to return to SP care. Week 5/6/7 SP review confirmed low levels of toxicity. No post-treatment dysphagia was observed. There was an incremental benefit of A$15.02 for SP staff costs and a recovery of 5.31 appointments per patient. CONCLUSION The pathway is a safe and effective service model to manage patients with HNC at low risk for dysphagia during RT, avoiding unnecessary SP appointments for the patient and service.

中文翻译：

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HNC放射治疗过程中吞咽困难风险低的患者的言语病理学服务提供模型的评估。

目的目前尚无循证指南来指导哪些头颈癌（HNC）患者在放射治疗（RT）期间需要定期的言语病理学（SP）支持。因此，某些服务使用“千篇一律”模型，可能为吞咽困难风险低的那些患者提供过度服务。这项研究评估了跨学科服务模型的临床安全性和有效性，该模型适用于被确定为RT期间吞咽困难的“低风险”患者。方法采用低风险途径对65例皮肤，甲状腺，腮腺，鼻子和唾液腺HNC患者进行前瞻性队列研究。排除基线吞咽困难（口服功能摄入分数≤5）的患者。该模型涉及营养师在第3、5周进行吞咽困难筛查。和6/7在预定的约会之内。有吞咽困难风险的患者转诊至SP进行评估，然后根据需要进行管理。为了验证模型，SP在RT期间第5/6/7周评估吞咽状态/毒性，并在RT后第2和6周确认吞咽困难状态。结果大多数（89.3％）患者不需要SP服务的吞咽困难支持。在筛查中确定的18例患者中，只有7例（10.7％）有足够的问题可以返回SP护理。5/6/7周SP检查确认毒性较低。没有观察到治疗后吞咽困难。SP员工费用增加了15.02澳元，每位患者的诊疗费用恢复了5.31澳元。结论该途径是一种安全有效的服务模型，可用于治疗RT吞咽困难风险低的HNC患者，