Flourishing Through Radiation Treatment and Patient-Reported Outcomes Among Head and Neck Cancer Survivors

Sunday, October 12, 2025

10:00 AM - 10:06 AM EDT

Location: 127

Disclosure(s):

Fendi Obuekwe, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The relationship between flourishing (a state in which all aspects of a person's life are good) during treatment and clinical outcomes is understudied in head and neck cancer (HNC). This analysis evaluates the association between flourishing and patient-reported outcomes (PROs) through radiation treatment.

Methods: HNC survivors undergoing radiotherapy at an NCI-designated cancer center from 2020-2024 completed sociodemographic surveys, the Secure Flourishing Index (SFI domains: happiness/satisfaction, mental/physical health, meaning/purpose, character/virtue, close social relationships, financial/material stability), and PROs (dysphagia, neck disability, insomnia, depression, anxiety) at pre- and 1-month post-radiation. Clinical characteristics were obtained from medical records. Analysis was conducted using linear regression models of flourishing scores over time.

Results: 240 survivors (75% male, 86.19% white, age 61.36+/-10.79 years, 47.72% oropharynx, 50.83% stage III-IVB) were included. For fixed pre-radiation flourishing scores: Higher post-radiation total SFI score was associated with lower symptoms of dysphagia (95% CI [-0.27, -0.03], p=0.02). Higher SFI score of mental/physical health was associated with lower symptoms of depression (95% CI [-1.19, -0.24], p< 0.001), anxiety (95% CI [-1.15, -0.26], p< 0.001), dysphagia (95% CI [-2.98, -0.54], p=0.01), and neck disability (95% CI [-2.04, -0.58], p< 0.001). Higher SFI score of meaning/purpose was associated with lower symptoms of depression (95% CI [-1.01, -0.14], p=0.01) and anxiety (95% CI [-0.83, -0.03], p=0.04). Higher SFI score of close social relationships was associated with lower symptoms of depression (95% CI [-1.15, -0.2], p=0.01), anxiety (95% CI [-1.23, -0.4], p< 0.001), neck disability (95% CI [-1.81, -0.42], p< 0.001), and insomnia (95% CI [-1.17, -0.12], p=0.02).

Conclusions: Greater flourishing through radiation treatment is associated with lower post-treatment symptom severity. Interventions that address multifaceted flourishing are needed to help alleviate symptom burden through treatment.

Presenting Author(s)

Fendi Obuekwe, BS

Medical Student
University of Pittsburgh School of Medicine
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

SG

Stephen Glass, MS

University of Pittsburgh School of Public Health, United States

Disclosure information not submitted.
YM

Yvonne M. Mowery, MD, PhD

University of Pittsburgh Department of Radiation Oncology, United States

Disclosure information not submitted.
DH

Daniel E. Hall, MD, MDiV, MHSc, FACS

University of Pittsburgh Department of Surgery, Veterans Affairs Pittsburgh Healthcare System, United States

Disclosure information not submitted.
Jonas T. Johnson, MD, FACS

Emeritus Distinguished Service Professor, Department of Otolaryngology; Professor, Department of Radiation Oncology Professor
University of Pittsburgh Department of Otolaryngology
Pittsburgh, PA, United States

Disclosure information not submitted.

Senior Author(s)

Marci L. Nilsen, PhD, RN, CHPN, FAAN

Professor
University of Pittsburgh Department of Otolaryngology-Head & Neck Surgery
Pittsburgh, Pennsylvania, United States

Disclosure information not submitted.