84 Background: Prospective evaluation of correlations between patient- (PROs) and physician-reported outcomes (PhROs) was conducted among a group of patients receiving stereotactic body radiation therapy (SBRT) for recurrent or locally advanced pancreatic cancer (PCA). Methods: Forty-two patients were treated with 25-33 Gy using SBRT in 5 fractions on a single-institution study. Eight outcomes (performance status, fatigue, pain, anorexia, nausea, vomiting, constipation, and diarrhea) were consistently evaluated by patients and providers prior to SBRT and 4-6 weeks post-SBRT. Patient-reported quality of life (QOL) metrics were assessed using the EORTC QLQ-C30 and QLQ-PAN26, while physician-reported toxicities were graded using the NCI CTCAE v4.0.A Pearson’s correlation was used to determine the relationship between PROs and PhROs. Results: Of the 42 enrolled patients, 36 had both PROs and PhROs collected before (median, 2.9 weeks) SBRT. Physician-reported pain, nausea, constipation, and diarrhea did not show a correlation with patient-reported overall health or QOL. Physician-reported fatigue showed a correlation with patient-reported pain (r > 0.5, p < 0.001) and QOL (r > -0.5, p < 0.001) but not fatigue (r < 0.3, p > 0.05). Nausea and constipation were the only PROs that did not correlate with their respective PhROs (nausea, r < 0.3, p > 0.05; constipation, r < 0.5, p = 0.07) or any of the other 7 PhROs. Only 24 had both PROs and PhROs collected 4-6 weeks after (median, 5.1 weeks) SBRT. Vomiting, constipation, and diarrhea were PhROs that demonstrated no correlation with patient-reported overall health or QOL. Physician-reported vomiting did not correlate with patient-reported vomiting (r < 0.3, p > 0.05) or any of the 7 other PROs. The correlation between patient- and physician-reported pain increased from pre- (r > 0.3, p = 0.03) to post- (r > 0.7, p < 0.0001) SBRT. Conclusions: Discrepancies among PROs and PhROs appear to exist in pancreatic-specific outcomes of interest such as constipation and diarrhea. Future health care teams may find it helpful to consider PROs to better manage symptoms and deliver more personalized care. Clinical trial information: NCT01781728.
Endoscopic Management of Pancreatic Cancer: From Diagnosis to Palliative Therapy
