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Quality of Life Research
Gepubliceerd in: Quality of Life Research 7/2017

28-02-2017

Electronic patient-reported outcomes and toxicities during radiotherapy for head-and-neck cancer

Auteurs: Joshua R. Niska, Michele Y. Halyard, Angelina D. Tan, Pamela J. Atherton, Samir H. Patel, Jeff A. Sloan

Gepubliceerd in: Quality of Life Research | Uitgave 7/2017

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Abstract

Purpose

To characterize quality of life (QOL) using real-time, electronic patient-reported outcomes (ePROs) and to evaluate adverse events (AEs) and supportive care during head-and-neck radiotherapy (RT) and concurrent chemoradiotherapy (CCRT).

Methods

Sixty-five patients undergoing head-and-neck RT completed electronic, real-time, 12-item linear analog self-assessments (LASA) at baseline, before biweekly appointments, and at the last week of RT. Changes in QOL domains between time points were calculated. Clinical data were collected from the institutional medical record. AEs were recorded at the same time points as the LASA and graded.

Results

During head-and-neck RT, most patients had clinically meaningful decreases in all QOL domains except level of support, financial concerns, and legal concerns. QOL domains with the most prevalent, clinically meaningful decreases were fatigue (75.4% of patients; 95% CI, 62.9–84.9%), social activity (70.8%; 95% CI, 58.0–81.1%), and overall QOL (70.8%; 95% CI, 58.0–81.1%). All patients had grade 2 AEs; 35.4% had grade 3 (50.0%, CCRT; 12.0%, RT; P = .002). Weight loss averaged 5.5 kg (6.9 kg, CCRT; 2.8 kg, RT; P < .001). Intravenous hydration was needed in 52.3% (77.5%, CCRT; 12.0%, RT; P < .001); feeding tube placement 40.0% (57.5%, CCRT; 12.0%, RT; P = .001); emergency department visits without hospitalization, 10.8%; and emergent hospitalization, 27.7% (37.5%, CCRT; 12.0%, RT; P = .04).

Conclusions

Head-and-neck RT, particularly CCRT, negatively impacts patients’ overall QOL, social activity, and fatigue, with frequent grade 3 AEs, weight loss, intravenous hydration, feeding tube placement, ED visits, and hospitalization. Real-time ePROs allow providers to monitor QOL at multiple time points during RT, potentially allowing early intervention to improve QOL and mitigate AEs.
vorige artikel Patient-reported symptoms of radiation dermatitis during breast cancer radiotherapy: a pilot study
volgende artikel Examining health-related quality of life patterns in women with breast cancer
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Metagegevens
Titel
Electronic patient-reported outcomes and toxicities during radiotherapy for head-and-neck cancer
Auteurs
Joshua R. Niska
Michele Y. Halyard
Angelina D. Tan
Pamela J. Atherton
Samir H. Patel
Jeff A. Sloan
Publicatiedatum
28-02-2017
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 7/2017
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-017-1528-2

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