Main Session
Sep
28
PQA 04 - Breast Cancer, Patient Reported Outcomes/QoL/Survivorship, Functional Radiation Medicine, Hematologic Malignancies, Palliative Care, and International/Global Oncology
Presenter(s)
Victoria Xu, BS - University of North Carolina at Chapel Hill, Chapel Hill, NC
V. Xu1, O. Morton1, P. Bramblett1, R. Silva1, X. Tan2, S. Sud1, E. L. Jones3, J. M. Wilson4, and A. A. Weiner1; 1Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, 2Gillings School of Global public health, University of North Carolina, Chapel Hill, NC, 3Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, 4Mayo Clinic, Rochester, MN
Purpose/Objective(s):
Women with gynecologic malignancies often experience a substantial symptom burden contributing to a diminished quality of life. Patient-reported outcomes (PROs) provide a systematic means of capturing patients’ subjective symptom experiences and facilitating patient-centered care. PRO data specific to patients undergoing radiation therapy (RT) for gynecologic cancers remains limited. To address this gap, we have implemented electronic PRO (ePRO) collection as part of a feasibility study in patients receiving RT for gynecologic cancers.Materials/Methods:
In this prospective observational study, 100 patients with gynecologic malignancies planned for RT were enrolled with planned ePRO. After consent, weekly ePROs were collected during RT, with follow-up surveys at 1, 2, and 6 weeks post-RT and then every three months for two years. Surveys were primarily emailed or completed during clinic visits. The primary objective of this study was to evaluate the feasibility of ePRO monitoring before, during, and for six weeks after RT for gynecologic cancer, with feasibility defined as =60% of patients completing 75% of symptom surveys between the baseline assessment and the six week post-RT timepoint.Results:
Of the 100 patients who provided consent, 98 were evaluable for analysis. The study cohort was predominantly White (n = 67), and most participants reported a Non-Hispanic/Latino ethnicity (n = 90). Cancer-directed therapies differed across disease groups. Cervical cancer (n=34) was managed predominantly with chemoradiotherapy and brachytherapy (BT) (n=29) with 8 patients receiving radiotherapy in the postoperative setting. Most patients with endometrial cancer (n=52) underwent initial surgical intervention (n= 51), with adjuvant radiation including EBRT alone (n=1), BT alone (n=29), or EBRT+BT (n=12). Vulvar/vaginal cancers (n=14) exhibited a balanced distribution of RT approaches (6 EBRT, 2 BT, 6 combined), 7 patients receiving post-operative RT. The baseline survey completion rate was 98%, while only 47% of participants completed at least 75% of the acute time-point assessments, falling below the predefined feasibility threshold of 60%.Conclusion:
The intent of the study was to generate evidence supporting the integration of ePROs symptom surveillance into routine gynecologic cancer care. Evaluation of the primary objective demonstrated that baseline survey collection was feasible; however, completion of acute time-point PROs declined substantially and did not meet the predefined feasibility threshold. Challenges with ePROs often disproportionately affect individuals impacted by social determinants of health such as limited digital literacy, inconsistent internet access, and lack of reliable devices, which may hinder equitable adoption and sustained engagement with ePRO platforms.