Résumé
Objective@#To explore the application and effect of the cancer case management led by cancer case managers in the whole processing management of nasopharyngeal carcinoma (NPC) patients.@*Methods@#A randomized controlled study was designed. 510 patients with nasopharyngeal carcinoma were randomly divided into two groups: the observation group (255 cases) and the control group (255 cases). The observation group adopted the case management led by cancer case managers, and the control group adopted the cancer case management. To evaluate the rate of seeing a doctor, the implementation rate of the treatment plan and the rate of the first follow-up visit between the two groups. M.D. Anderson symptom Inventory-head-neck (MDASI-H&N) was used to evaluate the symptom disturbance (the day of hospitalization, the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge).@*Results@#The treatment rate was 90.2% (230/255) in the observation group, 78.04% (199/255) in the control group, The rate of implementation of established treatment plans 99.57% (229/230) in the observation group and 90.95% (181/199) in the control group. The first follow-up rate was 98.70% (227/230) in the observation group and 84.42% (168/199) in the control group. The difference was statistically significant (Z=19.768, 15.207, 7.042, P < 0.01). In the observation group, the average value of symptom disturbance, the average severity of symptom distress and the average degree of symptom disturbance in 3 times (the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge) were (3.00±0.95) , (2.43±0.16) , (2.03±0.34) , (2.95±0.97) , (2.46±0.12) , (2.11±0.16) , (2.89±0.46) , (2.41±0.33) , (1.99±0.16) ; Significantly lower than the control group (3.69±1.51) , (2.82±0.23) , (2.42±0.13) , (3.88±1.39) , (2.87±0.34) , (2.54±0.22) , (3.61±0.75) , (2.72±0.42) , (2.38±0.17) , the difference has the statistical significance (t=-21.152—10.372, P < 0.01).@*Conclusion@#The case management led by cancer case manager can effectively improve the rate of seeing a doctor, the rate of completion of the plan and the rate of the first visit, and ensure the patients to receive effective, standard and full treatment in time. In addition, the case management can effectively improve the symptoms of patients and promote their early return to the community.