Abstract PD6-6: Identifying patients at higher risk of toxicity after breast radiotherapy: Analysis of patient-reported outcomes in the Michigan Radiation Oncology Quality Consortium cohort

2020 ◽  
Author(s):  
Reshma Jagsi ◽  
Kent Griffith ◽  
Frank Vicini ◽  
Jay Burmeister ◽  
Michael Dominello ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Patient Reported Outcomes ◽  
Breast Radiotherapy ◽  
Patient Reported

A novel integrative medicine educational program for radiation oncology patients: Feasibility and patient-reported outcomes.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21629-e21629
Author(s):  
Kareem Fakhoury ◽  
Mark J. Stavas
Keyword(s):  
Integrative Medicine ◽  
Radiation Oncology ◽  
Educational Program ◽  
Patient Reported Outcomes ◽  
Performance Status ◽  
Patient Characteristics ◽  
Clinic Visit ◽  
Clinical Workflow ◽  
Waiting Room ◽  
Patient Reported

e21629 Background: Integrative medicine uses complementary health approaches (CHAs) to improve wellness. Many patients use CHAs to manage acute and late toxicities of radiotherapy (RT). However, few patients disclose CHA use to their radiation oncologist. Patients acknowledge a need for improved education on CHAs and have shown interest in attending a hospital-based educational program. Here we assess the feasibility of implementing such a program and the associated patient-reported outcomes, including intention to disclose CHA use and patient satisfaction. Methods: A structured curriculum was designed as a collaboration between an academic institution’s integrative medicine center and radiation oncology department. Four one-hour lectures covered topics of meditation, yoga, massage therapy, and nutrition, each led by a topic expert. Lectures included didactic and interactive components. Individuals over age 18 and actively receiving RT were recruited by nurses, radiation therapists, and a designated study team member in the waiting room. Pre- and post-lecture surveys were used to assess patient characteristics, CHA use disclosure, satisfaction, and qualitative feedback. Results: 43 surveys were completed. The patient sample was 47% female, median age 63. The majority had breast or prostate cancer (60%). Of about 100 patients receiving RT each day, 5 to 7 attended each lecture. 36% of participants had disclosed their use of CHAs before the lecture; 67% intended to disclose their use after the lecture. 98% felt the lecture enhanced their patient experience with a median agreement of 8 on a 9-point Likert scale. Conclusions: This program is the first to increase satisfaction and CHA use disclosure. Patients expressed interest in learning simple, convenient, and effective tools to abate acute toxicities, rather than focus on chronic symptoms of remission and recovery. However, patient recruitment could not be effectively integrated into the clinical workflow. Attendance was limited by timing, transportation, and performance status. To increase reach and minimize cost, we suggest investigating a program that is integrated into the clinic visit or available in an online format.

Toward Improving Patients’ Experiences of Acute Toxicity From Breast Radiotherapy: Insights From the Analysis of Patient-Reported Outcomes in a Large Multicenter Cohort

2020 ◽  
Vol 38 (34) ◽  
pp. 4019-4029
Author(s):  
Reshma Jagsi ◽  
Kent A. Griffith ◽  
Frank Vicini ◽  
Thomas Boike ◽  
Jacob Burmeister ◽  
...  
Keyword(s):  
Supportive Care ◽  
Patient Reported Outcomes ◽  
Smoking Status ◽  
Breast Volume ◽  
Breast Pain ◽  
Breast Radiotherapy ◽  
Conventional Fractionation ◽  
Younger Age ◽  
Whole Breast Radiotherapy ◽  
Patient Reported

PURPOSE Understanding acute toxicities after whole-breast radiotherapy is important to inform patients, guide treatment decisions, and target supportive care. We evaluated patient-reported outcomes prospectively collected from a cohort of patients with breast cancer. METHODS We describe the maximal toxicity reported by 8,711 patients treated between 2012 and 2019 at 27 practices. Multivariable models identified characteristics associated with (1) breast pain, (2) bother from itching, stinging/burning, swelling, or hurting of the treated breast, and (3) fatigue within 7 days of completing whole-breast radiotherapy. RESULTS Moderate or severe breast pain was reported by 3,233 (37.1%): 1,282 (28.9%) of those receiving hypofractionation and 1,951 (45.7%) of those receiving conventional fractionation. Frequent bother from at least one breast symptom was reported by 4,424 (50.8%): 1,833 (41.3%) after hypofractionation and 2,591 (60.7%) after conventional fractionation. Severe fatigue was reported by 2,008 (23.1%): 843 (19.0%) after hypofractionation and 1,165 (27.3%) after conventional fractionation. Among patients receiving hypofractionated radiotherapy, younger age ( P < .001), higher body mass index (BMI; P < .001), Black ( P < .001) or other race ( P = .002), smoking status ( P < .001), larger breast volume ( P = .002), lack of chemotherapy receipt ( P = .004), receipt of boost treatment ( P < .001), and treatment at a nonteaching center predicted breast pain. Among patients receiving conventionally fractionated radiotherapy, younger age ( P < .001), higher BMI ( P = .003), Black ( P < .001) or other race ( P = .002), diabetes ( P = .001), smoking status ( P < .001), and larger breast volume ( P < .001) predicted breast pain. CONCLUSION In this large observational data set, substantial differences existed according to radiotherapy dose fractionation. Race-related differences in pain existed despite controlling for multiple other factors; additional research is needed to understand what drives these differences to target potentially modifiable factors. Intensifying supportive care may be appropriate for subgroups identified as being vulnerable to greater toxicity.

scholarly journals Patient-Reported Outcomes and Survivorship in Radiation Oncology: Overcoming the Cons

2014 ◽  
Vol 32 (26) ◽  
pp. 2920-2927 ◽  
Author(s):  
Farzan Siddiqui ◽  
Arthur K. Liu ◽  
Deborah Watkins-Bruner ◽  
Benjamin Movsas
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Clinical Oncology ◽  
Cancer Survivorship ◽  
Web Sites ◽  
Radiation Oncology ◽  
Patient Reported Outcomes ◽  
Radiation Therapy Oncology Group ◽  
Patient Reported

Purpose Although patient-reported outcomes (PROs) have become a key component of clinical oncology trials, many challenges exist regarding their optimal application. The goal of this article is to methodically review these barriers and suggest strategies to overcome them. This review will primarily focus on radiation oncology examples, will address issues regarding the “why, how, and what” of PROs, and will provide strategies for difficult problems such as methods for reducing missing data. This review will also address cancer survivorship because it closely relates to PROs. Methods Key articles focusing on PROs, quality of life, and survivorship issues in oncology trials are highlighted, with an emphasis on radiation oncology clinical trials. Publications and Web sites of various governmental and regulatory agencies are also reviewed. Results The study of PROs in clinical oncology trials has become well established. There are guidelines provided by organizations such as the US Food and Drug Administration that clearly indicate the importance of and methodology for studying PROs. Clinical trials in oncology have repeatedly demonstrated the value of studying PROs and suggested ways to overcome some of the key challenges. The Radiation Therapy Oncology Group (RTOG) has led some of these efforts, and their contributions are highlighted. The current state of cancer survivorship guidelines is also discussed. Conclusion The study of PROs presents significant benefits in understanding and treating toxicities and enhancing quality of life; however, challenges remain. Strategies are presented to overcome these hurdles, which will ultimately improve cancer survivorship.

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