Abstract
Purpose
We aimed to investigate whether patient self-evaluated symptoms transmitted via Internet can be used between planned visits to provide an early indication of disease relapse in lung cancer.
Methods
Between 2/2013 and 8/2013, 42 patients with lung cancer having access to Internet were prospectively recruited to weekly fill a form of 11 self-assessed symptoms called “sentinel follow-up”. Data were sent to the oncologist in real-time between planned visits. An alert email was sent to oncologist when self-scored symptoms matched some predefined criteria. Follow-up visit and imaging were then organized after a phone call for confirming suspect symptoms. Weekly and monthly compliances, easiness with which patients used the web-application and the accuracy of the sentinel follow-up for relapse detection were assessed and compared to a routine visit and imaging follow-up.
Results
Median follow-up duration was 18 weeks (8–32). Weekly and monthly average compliances were 79 and 94 %, respectively. Sixty percents of patients declared to be less anxious during the few days before planned visit and imaging with the sentinel follow-up than without. Sensitivity, specificity, positive, and negative predictive values provided by the sentinel (planned imaging) follow-up were 100 %(84 %), 89 %(96 %), 81 %(91 %), and 100 %(93 %), respectively and well correlated with relapse (pχ 2 < 0.001). On average, relapses were detectable 5 weeks earlier with sentinel than planned visit.
Conclusion
An individualized cancer follow-up that schedule visit and imaging according to the patient status based on weekly self-reported symptoms transmitted via Internet is feasible with high compliance. It may even provide earlier detection of lung cancer relapse and care.
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References
Selby JV, Beal AC, Frank L (2012) The Patient-Centered Outcomes Research Institute (PCORI) national priorities for research and initial research agenda. JAMA 307:1583–1584
Basch E, Artz D, Dulko D, Scher K et al (2005) Patient online self-reporting of toxicity symptoms during chemotherapy. J Clin Oncol 23:3552–3561
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):1563–1570
Gilbert S, Reid KR, Lam MY et al (2000) Who should follow up lung cancer patients after operation? Ann Thorac Surg 69(6):1696–1700
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):1185–1190
Vansteenkiste J, De Ruysscher D, Eberhardt WE et al (2013) ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol
Denis F, Viger L, Charron A et al (2013) Detecting lung cancer relapse using self-evaluation forms weekly filled at home: the sentinel follow-up. Support Care Cancer
Basch E, Iasonos A, Barz A et al (2007) Long-term toxicity monitoring via electronic patient-reported outcomes in patients receiving chemotherapy. J Clin Oncol 25:5374–5380
Judson TJ, Bennett AV, Rogak LJ, Sit L et al (2013) Feasibility of long-term patient self-reporting of toxicities from home via the Internet during routine chemotherapy. J Clin Oncol 31(20):2580–2585
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):2004–2009
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 22:330–353
NCCN Guidelines™ Version 1. (2012) Non-Small Cell Lung Cancer
Narducci F, Grande R, Mentuccia L et al (2012) Symptom improvement as prognostic factor for survival in cancer patients undergoing palliative care: a pilot study. Support Care Cancer 20(6):1221–1226
Liao YC, Liao WY, Shun SC et al (2011) Symptoms, psychological distress, and supportive care needs in lung cancer patients. Support Care Cancer 19(11):1743–1751
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Denis, F., Viger, L., Charron, A. et al. Detection of lung cancer relapse using self-reported symptoms transmitted via an Internet Web-application: pilot study of the sentinel follow-up. Support Care Cancer 22, 1467–1473 (2014). https://doi.org/10.1007/s00520-013-2111-1
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DOI: https://doi.org/10.1007/s00520-013-2111-1