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 : 2025-02-01 Epub 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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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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患者报告的结果数据影响放射治疗的常规回顾：改善研究结果。

背景：放射肿瘤学家在每周的治疗访视（otv）中密切监测患者。本研究探讨了otv期间常规的患者报告结果测量（PROMs）是否会改变医生对治疗毒性的看法，并为症状管理提供信息。患者和方法：IMPROVE是一项单臂前瞻性多中心试验，于2020年至2023年进行。局部晚期或少转移性胸部或胃肠道癌症患者接受明确意图放疗，伴或不伴化疗，以及他们的医生。患者在otv前完成了14个问题的疾病特异性PROM。医生根据临床数据/评估评估患者的总体毒性负担，然后重新评估患者的毒性负担，并在PROM审查后报告管理变化。放疗结束时，医生填写一份反馈表格。prom和结果数据收集使用电子或纸质表格。我们报告由医师评估的负担评分和因PROMs引起的症状管理的任何变化。结果：纳入的100例患者（49例学术，51例社区）年龄为70 岁（中位数），女性为51 %，高加索人为81 %，ECOG 0-1为95 %，94 %同时接受化疗。中位放射剂量为60 Gy，在6 周内给予。prom可用于607/629(97 %)otv的审查：完整的433/629(69 %)，部分174/629（28 %）。75/100例患者(75 %；95 % CI:65 %-83 %)，PROM审查导致医生报告的负担评分发生任何变化，对于50/100例患者(50 %；95 % CI:40 %-60 %)患者治疗管理的任何变化。学术实践和社区实践的负担评分和管理变化率相似(78 % vs. 73 %；53 % vs. 47 %)。在78/100的反馈表格患者中，医生同意/强烈同意PROMs提高了患者的护理质量（91 %）。结论：PROM审查改变了放射肿瘤学家对75% %患者的治疗毒性评估和50% %患者的护理提供。

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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.