Development and pilot implementation of a remote monitoring system for acute toxicity using electronic patient-reported outcomes (ePROs) for patients undergoing radiation therapy for breast cancer

2021 ◽  
Author(s):  
Kaitlyn Lapen ◽  
Christopher Sabol ◽  
Amy L. Tin ◽  
Kathleen Lynch ◽  
Alyse Kassa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Acute Toxicity ◽  
Monitoring System ◽  
Remote Monitoring ◽  
Patient Reported Outcomes ◽  
Remote Monitoring System ◽  
Patient Reported ◽  
Pilot Implementation

scholarly journals Analysis of Radiation Dose to the Shoulder by Treatment Technique and Correlation With Patient Reported Outcomes in Patients Receiving Regional Nodal Irradiation

2021 ◽  
Vol 11 ◽  
Author(s):  
Jose G. Bazan ◽  
Dominic DiCostanzo ◽  
Karen Hock ◽  
Sachin Jhawar ◽  
Karla Kuhn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Radiation Dose ◽  
Patient Reported Outcomes ◽  
Late Complication ◽  
Treatment Technique ◽  
Regional Nodal Irradiation ◽  
Patient Reported ◽  
The Impact ◽  
Dash Questionnaire

Background/PurposeShoulder/arm morbidity is a late complication of breast cancer treatment with surgery and regional nodal irradiation (RNI). We set to analyze the impact of radiation technique [intensity modulated radiation therapy (IMRT) or 3D conformal radiation therapy (3DCRT)] on radiation dose to the shoulder with a hypothesis that IMRT use results in smaller volume of shoulder receiving radiation. We explored the relationship of treatment technique on long-term patient-reported outcomes using the quick disabilities of the arm, shoulder, and hand (q-DASH) questionnaire.Materials/MethodsWe identified patients treated with adjuvant RNI (50 Gy/25 fractions) from 2013 to 2018. We retrospectively contoured the shoulder organ-at-risk (OAR) from 2 cm above the ipsilateral supraclavicular (SCL) planning target volume (PTV) to the inferior SCL PTV slice and calculated the absolute volume of shoulder OAR receiving 5–50 Gy (V5–V50). We identified patients that completed a q-DASH questionnaire ≥6 months from the end of RNI.ResultsWe included 410 RNI patients: 54% stage III, 72% mastectomy, 35% treated with IMRT. IMRT resulted in significant reductions in the shoulder OAR volume receiving 20–50 Gy vs. 3DCRT. In total, 82 patients completed the q-DASH. The mean (SD) q-DASH=25.4 (19.1) and tended to be lower with IMRT vs. 3DCRT: 19.6 (16.4) vs. 27.8 (19.8), p=0.078.ConclusionWe found that IMRT reduces radiation dose to the shoulder and is associated with a trend toward reduced q-DASH scores ≥6 months post-RNI in a subset of our cohort. These results support prospective evaluation of IMRT as a technique to reduce shoulder morbidity in breast cancer patients receiving RNI.

scholarly journals Cardiopulmonary-related patient-reported outcomes in a randomized clinical trial of radiation therapy for breast cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hilde Van Parijs ◽  
Vincent Vinh-Hung ◽  
Christel Fontaine ◽  
Guy Storme ◽  
Claire Verschraegen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Survival Analysis ◽  
Chest Wall ◽  
Patient Reported Outcomes ◽  
Trial Registration ◽  
Mixed Effect ◽  
Node Positive ◽  
Patient Reported

Abstract Background Long-term prospective patient-reported outcomes (PRO) after breast cancer adjuvant radiotherapy is scarce. TomoBreast compared conventional radiotherapy (CR) with tomotherapy (TT), on the hypothesis that TT might reduce lung-heart toxicity. Methods Among 123 women consenting to participate, 64 were randomized to CR, 59 to TT. CR delivered 50 Gy in 25 fractions/5 weeks to breast/chest wall and regional nodes if node-positive, with a sequential boost (16 Gy/8 fractions/1.6 weeks) after lumpectomy. TT delivered 42 Gy/15 fractions/3 weeks to breast/chest wall and regional nodes if node-positive, 51 Gy simultaneous-integrated-boost in patients with lumpectomy. PRO were assessed using the European Organization for Research and Treatment of Cancer questionnaire QLQ-C30. PRO scores were converted into a symptom-free scale, 100 indicating a fully symptom-free score, 0 indicating total loss of freedom from symptom. Changes of PRO over time were analyzed using the linear mixed-effect model. Survival analysis computed time to > 10% PRO-deterioration. A post-hoc cardiorespiratory outcome was defined as deterioration in any of dyspnea, fatigue, physical functioning, or pain. Results At 10.4 years median follow-up, patients returned on average 9 questionnaires/patient, providing a total of 1139 PRO records. Item completeness was 96.6%. Missingness did not differ between the randomization arms. The PRO at baseline were below the nominal 100% symptom-free score, notably the mean fatigue-free score was 64.8% vs. 69.6%, pain-free was 75.4% vs. 75.3%, and dyspnea-free was 84.8% vs. 88.5%, in the TT vs. CR arm, respectively, although the differences were not significant. By mixed-effect modeling on early ≤2 years assessment, all three scores deteriorated, significantly for fatigue, P ≤ 0.01, without effect of randomization arm. By modeling on late assessment beyond 2 years, TT versus CR was not significantly associated with changes of fatigue-free or pain-free scores but was associated with a significant 8.9% improvement of freedom from dyspnea, P = 0.035. By survival analysis of the time to PRO deterioration, TT improved 10-year survival free of cardiorespiratory deterioration from 66.9% with CR to 84.5% with TT, P = 0.029. Conclusion Modern radiation therapy can significantly improve long-term PRO. Trial registration Trial registration number ClinicalTrials.govNCT00459628, April 12, 2007 prospectively.

Exercise behavior and patient-reported outcomes in women with early breast cancer receiving locoregional radiation therapy

2015 ◽  
Vol 5 (4) ◽  
pp. e275-e281 ◽  
Author(s):  
Ritu Arya ◽  
Sharareh Siamakpour-Reihani ◽  
Manisha Palta ◽  
Lisa Massa ◽  
Gloria Broadwater ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Early Breast Cancer ◽  
Patient Reported Outcomes ◽  
Exercise Behavior ◽  
Patient Reported
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