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Supportive Care in Cancer

, Volume 22, Issue 1, pp 79–85 | Cite as

Detecting lung cancer relapse using self-evaluation forms weekly filled at home: the sentinel follow-up

  • Fabrice DenisEmail author
  • Louise Viger
  • Alexandre Charron
  • Eric Voog
  • Christophe Letellier
Original Article

Abstract

Purpose

We aimed to assess if patients' ratings of symptoms can be used to provide an early indication of disease recurrence or progression in lung cancer. We proposed a simple self-evaluation form made of six clinical parameters weekly scored by patients at home as a follow-up—here named sentinel—to improve relapse detection. Its performances were compared to those of a routine imaging follow-up.

Methods

Patients with lung cancer were prospectively recruited to weekly fill a form at home for self-assessing weight, fatigue, pain, appetite, cough, and breathlessness during at least 4 months. Each patient reported weight and assessed the severity of each symptom by grading it from 0 (no symptom) to 3 (major symptom). A score was retrospectively designed for discriminating patients with relapse from those without. Accuracy of relapse detection was then compared to values of the routine planned imaging.

Results

Forty-three patients were included in our center and recruited for 16 weeks or more follow-up during which at least one tumor imaging assessment was performed (CT scan or PET-CT). Forty-one completed the form weekly. Sensitivity, specificity, and positive and negative predictive values of sentinel were high (86, 93, 86 % and 93 vs 79, 96, 92, and 90 % for routine imaging—p = ns) and well correlated with relapse (2 > 0.001). Moreover, relapses were detectable with sentinel on average 6 weeks earlier than the planned imaging.

Conclusion

This study suggests that a personalized cancer follow-up based on a weekly self-evaluation of six symptoms is feasible and may be accurate for earlier detection of lung cancer relapse, allowing integration in electronic devices for real-time patient outcome follow-up.

Keywords

Lung cancer Follow-up Supportive care Personalized medicine Early relapse detection 

Notes

Acknowledgments

None

Conflicts of interest

There are no financial disclosures, conflicts of interest, for the authors, and no funding sources for the manuscript.

References

  1. 1.
    French National Institute report (2013) Survival of patients with cancer 1989 – 2007Google Scholar
  2. 2.
    Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, et al. (eds) (2012) SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD. Based on November 2011 SEER data submission, posted to the SEER web site, April 2012. Available: http://seer.cancer.gov/csr/1975_2009_pops09/. Accessed 09 January 2012
  3. 3.
    Rubins J, Unger M, Colice GL (2007) Follow-up and surveillance of the lung cancer patient following curative intent therapy, ACCP evidence-based clinical practice guideline (2nd edn.). Chest 132:355S–367SPubMedCrossRefGoogle Scholar
  4. 4.
    Crino L, Weder W, van Meerbeeck J, Felip E (2010) On behalf of the ESMO guidelines working group. Early stage and locally advanced (non-metastatic) non-small-cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v103–v115PubMedCrossRefGoogle Scholar
  5. 5.
    Van Loon J, Grutters J, Wanders R et al (2009) Follow-up with 18FDG-PET-CT-CT after radical radiotherapy with or without chemotherapy allows the detection of potentially curable progressive disease in non-small cell lung cancer patients: a prospective study. Eur J Cancer 45:588–595PubMedCrossRefGoogle Scholar
  6. 6.
    Younes RN, Gross JL, Deheinzelin D (1999) Follow-up in lung cancer: how often and for what purpose? Chest 115(6):1494–1499PubMedCrossRefGoogle Scholar
  7. 7.
    Walsh GL, O'Connor M, Willis KM et al (1995) Is follow-up of lung cancer patients after resection medically indicated and cost-effective? Ann Thorac Surg 60(6):1563–1570PubMedCrossRefGoogle Scholar
  8. 8.
    Gilbert S, Reid KR, Lam MY et al (2000) Who should follow up lung cancer patients after operation? Ann Thorac Surg 69(6):1696–1700PubMedCrossRefGoogle Scholar
  9. 9.
    Westeel V, Choma D, Clement F et al (2000) Relevance of an intensive postoperative follow-up after surgery for non-small cell lung cancer. Ann Thorac Surg 70(4):1185–1190PubMedCrossRefGoogle Scholar
  10. 10.
    Walsh D, Rybicki L, Nelson KA, Donnelly S (2002) Symptoms and prognosis in advanced cancer. Support Care Cancer 10:385–388PubMedCrossRefGoogle Scholar
  11. 11.
    Donnelly S, Walsh D, Rybicki L (1995) The symptoms of advanced cancer: identification of clinical and research priorities by assessment of prevalence and severity. J Palliat Care 11(1):27–32PubMedGoogle Scholar
  12. 12.
    Ross PJ, Ashely S, Norton A, Priest K, Waters JS, Eisen T, Smith IE, O'Brien MER (2004) Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers? Br J Cancer 90:1905–1911PubMedCrossRefGoogle Scholar
  13. 13.
    Khalid U, Spiro A, Baldwin C, Sharma B, McGough C, Norman AR, Eisen T, O'Brien ME, Cunningham D, Andreyev HJ (2007) Symptoms and weight loss in patients with gastrointestinal and lung cancer at presentation. Support Care Cancer 15(1):39–46PubMedCrossRefGoogle Scholar
  14. 14.
    Kirkova J, Davis MP, Walsh D, Tiernan E, O'Leary N, LeGrand SB et al (2006) Cancer symptom assessment instruments. J Clin Oncol 24(9):1459–1473PubMedCrossRefGoogle Scholar
  15. 15.
    Pietanza MC, Basch EM, Lash A et al (2013) Harnessing technology to improve clinical trials: study of real-time informatics to collect data, toxicities, image response assessments, and patient-reported outcomes in a phase II clinical trial. J Clin Oncol 31(16):2004–2009PubMedCrossRefGoogle Scholar
  16. 16.
    Liao YC, Liao WY, Shun SC, Yu CJ, Yang PC, Lai YH (2011) Symptoms, psychological distress, and supportive care needs in lung cancer patients. Support Care Cancer 19(11):1743–1751PubMedCrossRefGoogle Scholar
  17. 17.
    Yumuk PF, Mohammed N, Maat AP et al (2012) How do lung cancer specialists follow their patients with stage II NSCLC after definitive treatment ? a short report. Eur J Cancer 48(14):2163–2165PubMedCrossRefGoogle Scholar
  18. 18.
    Pfister DG, Johnson DH, Azzoli CG et al (2004) American society of clinical oncology treatment of unresectable non-small-cell lung cancer guideline: update 2003. J Clin Oncol 22:330–353PubMedCrossRefGoogle Scholar
  19. 19.
    NCCN Guidelines™ Version 1.2012 Non-Small Cell Lung CancerGoogle Scholar
  20. 20.
    Oechsle K, Goerth K, Bokemeyer C, Mehnert A (2013) Symptom burden in palliative care patients: perspectives of patients, their family caregivers, and their attending physicians. Support Care Cancer 21(7):1955–1962PubMedCrossRefGoogle Scholar
  21. 21.
    Letellier C, Denis F, Aguirre LA (2013) What can be learned from a chaotic cancer model ? J Theoretical Biology 322:7–16CrossRefGoogle Scholar
  22. 22.
    Narducci F, Grande R, Mentuccia L, Trapasso T, Sperduti I, Magnolfi E, Fariello AM, Gemma D, Gamucci T (2012) Symptom improvement as prognostic factor for survival in cancer patients undergoing palliative care: a pilot study. Support Care Cancer 20(6):1221–1226PubMedCrossRefGoogle Scholar
  23. 23.
    Reilly CM, Bruner DW, Mitchell SA, Minasian LM, Basch E, Dueck AC, Cella D, Reeve BB (2013) A literature synthesis of symptom prevalence and severity in persons receiving active cancer treatment. Support Care Cancer 21:1525–1550PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Fabrice Denis
    • 1
    • 2
    Email author
  • Louise Viger
    • 2
  • Alexandre Charron
    • 1
  • Eric Voog
    • 1
  • Christophe Letellier
    • 2
  1. 1.Jean Bernard Center/Victor Hugo ClinicLe MansFrance
  2. 2.CORIA—University of RouenSaint-Etienne du Rouvray cedexFrance

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