Routine review of patient-reported outcome data influences radiotherapy care: IMPROVE study results.

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2024-12-18 DOI:10.1016/j.radonc.2024.110688

Khinh Ranh Voong, Siyao Li, Chen Hu, Ori Shokek, Russell K Hales, Jeffrey Meyer, Stephen Greco, Todd McNutt, Colin Hill, Kathryn Lowe, James Huang, Jean Wright, Amol Narang, Aditya Halthore, Andrea Brown, Shing Lee, Claire Snyder

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引用次数: 0

Abstract

Background: Radiation oncologists closely monitor patients during weekly on-treatment visits (OTVs). This study examines whether routine patient-reported outcome measures (PROMs) during OTVs change physicians' perceptions of treatment-toxicity and inform symptom-management.

Patient and methods: IMPROVE is a single-arm prospective multicenter trial, conducted from 2020 to 2023. Patients with locally-advanced or oligometastatic thoracic or gastrointestinal cancers receiving definitive-intent radiation, with or without chemotherapy, and their physicians enrolled. Patients completed a 14-question disease-specific PROM in-clinic prior to OTVs. Physicians rated their patient's global toxicity-burden based on clinical data/assessments, then re-rated their patient's toxicity-burden and reported management-changes after PROM review. At radiotherapy end, physicians completed a Feedback Form. PROMs and outcome-data collection used electronic or paper forms. We report any change in physician-assessed burden-score and symptom-management due to PROMs.

Results: The 100 patients enrolled (49 academic, 51 community-based) were 70 years old (median), 51 % female, 81 % Caucasian, 95 % ECOG 0-1, and 94 % received concurrent chemotherapy. The median radiation dose was 60 Gy, delivered over 6 weeks. PROMs were available for review for 607/629 (97 %) OTVs: full 433/629 (69 %), partial 174/629 (28 %). For 75/100 patients (75 %; 95 % CI:65 %-83 %), PROM review resulted in any change in physician-reported burden-score, and for 50/100 patients (50 %; 95 % CI:40 %-60 %) any change in patients' on-treatment management. Rates of burden-score and management-changes were similar between academic and community-based practices (78 % vs. 73 %; 53 % vs. 47 %, respectively). For 78/100 patients with Feedback Forms, physicians agreed/strongly agreed that PROMs improved patients' quality-of-care (91 %).

Conclusions: PROM review changes radiation oncologists' on-treatment toxicity assessment in 75 % and care delivery in 50 % of their patients.

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.