Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 7, 2022
Date Accepted: Jan 31, 2023
Surveillance of symptom burden using the Patient-Reported Outcome Version of the CTCAE in patients with various types of cancers during chemo-radiation therapy: a real-world study
ABSTRACT
Background:
Over 90% of patients with cancer experience one or more symptoms caused directly by cancer or its treatment. Thus, it has been recommended that surveillance of symptom burden should be performed and managed during cancer treatment. However, differences in symptom profiles in various patients with cancer have not been fully elucidated for use in surveillance in the real world.
Objective:
We aimed to surveillance the symptoms burden in patients with various types of cancers during chemotherapy or radiation therapy using PRO-CTCAE and its impact on quality of life.
Methods:
We performed a cross-sectional study of 1,352 patients undergoing chemotherapy, radiation therapy, or both in the Seoul-Metropolitan area, South Korea between December 2017 and January 2018. To surveillance cancer-specific symptom burden, we developed 10 subsets for using the PRO-CTCAE-Korean. Quality of Life (QoL) was assessed using the EORTC C-30. Participants answered questions prior to their clinic appointments on tablet computers.
Results:
The mean age (SD) of the patients was 55.0 (11.9) years, and 39.9% were male. Overall, symptoms in gastrointestinal category were the most dominant in all cancers. Fatigue (76.48%), decreased appetite (65.38%), and numbness & tingling (57.54%) were most frequently reported. Patients reported more local symptoms caused by a specific cancer. In terms of non-site-specific symptoms, patients commonly reported concentration (43.42%), anxiety (47.86%), and general pain (44.75%). Worsening PRO-CTCAE scores was associated with poor QoL (e.g. fatigue (Coef =-8.15 ; 95% CI = -9.32, -6.97), achieve and maintain erection (Coef = -8.07 ; 95% CI = -14.52, -1.61), concentration (Coef = -7.54 ; 95% CI = -9.06, -6.01) and dizziness (Coef =-7.24 ; 95% CI = -8.92, -5.55).
Conclusions:
The frequency and severity of symptoms were differed by cancer types. Higher symptom burden was associated with poor QoL suggesting the importance of appropriate surveillance of PRO symptoms during cancer treatment.
Citation
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